Bacterial meningitis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Differential diagnosis

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

References

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