Bacterial meningitis differential diagnosis
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Bacterial meningitis Microchapters |
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Diagnosis |
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Treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Differential diagnosis
Bacterial meningitis may mimick other diseases in terms of clinical signs and symptoms. It is important to differentiate meningitis from other diseases with similar presentation. Once the diagnsis of meningitis is confirmed, the next step may be to differentiate different types of meningitis on the basis of CSF examnination:
Differentiating bacterial meningite is from other diseases
Differentiating bacterial meningitis from other causes of meningitis
| Cerebrospinal Fluid | |||||
| Normal Levels | Acute Bacterial M. | Acute Viral M. | TB M. | Neuroborreliosis | |
| Cells/ul | < 5 | In the 1000s | In the 100s | In the 100s | Some 100 |
| Cells | Lymph:Monos 7:3 | Gran. > Lymph. | Lymph. > Gran. | Various leukos | Lymph. monocytic |
| Total Protein (mg/dl) | 45-60 | Typically 100-500 | Typically normal | Typically 100-200 | Typically up to 350 |
| Glucose Ratio (CSF/plasma) | Typically > 0.5 | < 0.3 | > 0.6 | < 0.5 | Normal |
| Lactate (mmol/l) | < 2.1 | > 2.1 | < 2.1 | > 2.1 | - |
| Others | ICP: 6-22 (cm H2O) | PCR of HSV-DNA | PCR of TBC-DNA | IgG/IgM CSF/Serum Ratio |