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ID:604 Cerebro-spinal fluid (Microscopy and Culture)
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DescriptionSuspected bacterial meningitis should be confirmed by CSF culture unless LP is contraindicated. A high WBC count along with a positive Gram stain supports a diagnosis of bacterial meningitis. Where subarachnoid bleed is suspected please send 2 tubes (number 1 & 3) so that comparison can be made between a traumatic tap and sanguineous CSF. Please number containers clearly. Culture results are more sensitive than the Gram stain. Pre antibiotic CSF will give better culture yields but this does not imply to withhold antibiotic therapy. Where possible, send separate tubes for separate tests, and list these explicitly on the request form. For cryptococcal or AAFB investigations, please send a separate specimen. Likewise any specimens for cytopathological examination should be sent separately as MC&S will render specimens unusable for this. If Xanthachromia is required, send a tube to Biochemistry. This should be covered to avoid light damage. If viral meningitis is suspected a separate request and sample should be sent for PCR (see Cerebro-spinal fljuid (Viral PCR)). CSF from patients with shunts and EVDs can also be examined. If shunt infection is suspected, collect a sample of CSF from the relevant part(s) of the shunt apparatus. (Ensure samples are labelled to indicate the origin of the sample). Please do NOT submit shunt tubing, tip, or reservoir for examination.
Indication
Additional InfoEnsure sufficient CSF is collected for the tests requested. If in doubt, contact the Medical Microbiologist or on-call Biomedical Scientist. This is classed as an urgent test. The laboratory or on-call biomedical scientist should be contacted when sending the specimen. Shunt/drain apparatus (ie tubing, tip, reservoir etc) is a poor specimen because it cannot be satisfactorily examined in the laboratory. Shunt apparatus will NOT normally be examined. Please send sample(s) of the fluid within the affected part(s) of the shunt apparatus.
Concurrent Testsna
Dietary Requirementsna
Interpretation

DepartmentMicrobiology
SampleCSF
TubeUniversal Sterile
Tube Picture
Collection ConditionsObserve aseptic sampling technique for performing lumbar puncture and decanting sample into sterile universal containers. Transport the sample to the laboratory as quickly as possible. Note: The recovery of anaerobes is compromised if the transport time exceeds 3 hours.
Min. Vol0.5mL
Freq.once

Ref. Range (Male)
Ref. Range (Female)
Ref. Range (Paed)
Ref. Range Notes
Units - Not Defined -
IP Acute TAT5 days
IP Routine TAT5 days
GP Acute TAT- Not Defined -
GP Routine TAT- Not Defined -
Turnround CommentCell count and microscopy will be available within 1 hour if the lab is notified prior to arrival Turn around time will be 7 days for Neurosurgery wards and the following clinical details: Brain abscess, Ventriculitis, Shunt infection, Reservoir, Neurosurgery, Post otitis media with complications.

Originally edited by : Dr M Denton. Review due on 15/05/2019 11:11:47. Published By K Roberts on 15/05/2018 11:11:47.