Meningococcemia laboratory tests
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Meningococcemia Microchapters |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Laboratory Findings
Electrolyte and Biomarker Studies
- Blood cultures were positive in 41.4% of 400 cultures in one series of patients with meningococcal disease.
- Cerebrospinal fluid (CSF) culture and gram stain were positive in 94% of patients in the same series.
- The ability to culture the meningococcus from CSF will not be substantially reduced if the cultures are obtained within one hour of antibiotic administration.
- One series revealed a median leukocyte count of approximately 1200 in CSF (range 10 to 65,000/mm). Approximately 75% had a CSF glucose level less than 40 mg/100 mL. CSF protein ranged from 25 to over 800 mg/100 mL with a median value of 150 mg/100 mL.
- Polymerase chain reaction (PCR) has been shown in a study with 54 samples to be 91% sensitive and specific, particularly useful when cultures may be negative due to prior antibiotic administration.
- Latex agglutination can detect A, B, C, Y, and W-135 though the sensitivity of detecting serogroup B is low.
HUSSEIN AND SHAFRAN CANADIAN REVIEW OF BACTERIAL MENINGITIS
| Cloudy CSF | 78% |
| CSF >= 1000 WBC/mm3 | 56% |
| CSF >= 10,000 WBC/mm3 | 14% |
| CSF Neutrophil predominance | 90% |
| CSF Glucose =< 50 mg/deL | 70% |
| CSF Protein > 200 mg/dL | 66% |
| Gram Stain without bacteria | 53% |
| Gram Stain Neg --> Culture Pos | 47% |