Viral meningitis lumbar puncture

Jump to navigation Jump to search

Meningitis main page

Viral meningitis Microchapters


Patient Information


Historical Perspective




Differentiating Viral meningitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings





Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Viral meningitis lumbar puncture On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Viral meningitis lumbar puncture

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse

NICE Guidance

FDA on Viral meningitis lumbar puncture

CDC onViral meningitis lumbar puncture

Viral meningitis lumbar puncture in the news

Blogs on Viral meningitis lumbar puncture

Viral meningitis

Risk calculators and risk factors for Viral meningitis lumbar puncture

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]


Lumbar puncture is the most important specific diagnostic procedure for detecting viral meningitis and to exclude other causes of meningitis. It is indicated for all suspected patients of viral meningitis. The CSF findings in case of viral meningitis include high glucose concentration, normal or slightly high protein, increased number of lymphocytes and lactates level of <2.1 mmol/l. CT scan should be done before lumbar puncture procedure in the immune deficient patient or patients with increased intracranial pressure.[1][2]

Lumbar puncture

Indicaitons of lumbar puncture

Lumbar puncture is indicated in all pateints with strong suspicion of meningitis for the following reasons:[3]

  • To confirm the diagnosis
  • To differentiate the different causes of meningitis
  • To diagnose the specific causative agent for bacterial meningitis
  • To start the appropriate treatment as early as possible to prevent complications

Findings of lumbar puncture in viral meningitis

  • High count of white blood cells (10-100 cells/µL)
  • High glucose ratio (CSF/plasma) >0.6
  • Normal protein level but may be slightly elevated
  • Increased number of the lymphocytes > granulocytes
  • Lactate levels <2.1

Contraindications of lumbar puncture

Contraindications of lumbar puncture include the following:[3]

  • Increased intracranial pressure
  • Mass lesion such as tumour
  • Thrombocytopenia
  • Bleeding diathesis


  1. Casasoprana A, Hachon Le Camus C, Claudet I, Grouteau E, Chaix Y, Cances C; et al. (2013). "[Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases]". Arch Pediatr. 20 (6): 594–600. doi:10.1016/j.arcped.2013.03.022. PMID 23639837.
  2. Negrini B, Kelleher KJ, Wald ER (2000). "Cerebrospinal fluid findings in aseptic versus bacterial meningitis". Pediatrics. 105 (2): 316–9. PMID 10654948.
  3. 3.0 3.1 Doherty CM, Forbes RB (2014). "Diagnostic Lumbar Puncture". Ulster Med J. 83 (2): 93–102. PMC 4113153. PMID 25075138.