Clinical parameters do not predict infection in patients with external ventricular drains: a retrospective observational study of daily cerebrospinal fluid analysis

A retrospective review was conducted of patients with external ventricular drains (EVDs) in situ in order to ascertain the utility of daily cerebrospinal fluid (CSF) analysis in such patients. All laboratory requests for CSF analysis, which were sent to the Microbiology Department, Auckland City Hospital, New Zealand, were reviewed to identify patients with EVDs in situ. The patients' clinical records were reviewed and information was obtained regarding their age, ethnicity, indication for EVD, duration of EVD, CSF analysis results, daily temperatures, Glasgow Coma Scale (GCS) and the presence of other infections. For CSF samples that grew organisms, the patients' notes were reviewed to ascertain whether the organism was a contaminant or was representative of EVD-associated ventriculitis. A total of 454 CSF specimens from 60 patients were reviewed. Of the 56 CSF specimens that were culture-positive, 40 (71 %) were found to reflect clinical infection. Routine CSF analysis identified nine episodes of EVD-associated ventriculitis. Coagulase-negative staphylococci and Staphylococcus epidermidis were the most common isolates and were associated with ventriculitis approximately half of the time. Gram-negative isolates were less frequently isolated, but, when present, were always associated with ventriculitis. This study found that patient temperature and GCS did not allow early prediction of EVD-associated ventriculitis.

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Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders

Pesquisa Veterinária Brasileira ◽

10.1590/1678-5150-pvb-6540 ◽

2020 ◽

Vol 40 (5) ◽

pp. 346-354

Author(s):

Antônio Carlos L. Câmara ◽

Mariana C. Gonzaga ◽

Thaís M. Ziober ◽

Cintia Regina R. Queiroz ◽

Tayná C.M. Fino ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Neurological Disorders ◽

Viral Infections ◽

Experimental Studies ◽

Clinical Signs ◽

Pathological Findings ◽

Cerebrospinal Fluid Analysis ◽

Cns Diseases ◽

Fluid Analysis ◽

Csf Analysis

ABSTRACT: Ruminants may be affected by a wide variety of central nervous system (CNS) diseases. Cerebrospinal fluid (CSF) analysis forms the basis for ante mortem diagnostic evaluation of ruminants with clinical signs involving the CNS. Despite its importance as a tool to aid diagnosis, data regarding CSF examinations in spontaneous cases of CNS diseases in ruminants from Brazil are limited, and most reports involve experimental studies. Therefore, this study aimed to report the results of CSF analysis in 58 ruminants showing signs of neurological disorders. CSF samples for analysis were obtained from 32 cattle, 20 sheep, and 6 goats by cerebello-medullary cistern (n=54) or lumbosacral space (n=4) puncture. These ruminants showed neurological signs related to viral (n=13), mycotic (n=3), or bacterial (n=15) infections, and toxic (n=21), traumatic (n=4), or congenital disorders (n=2). CSF analysis from ruminants with viral infections presented lymphocytic pleocytosis, even though CSF showed no changes in several cases of rabies. Neutrophilic pleocytosis, cloudiness, presence of fibrin clots, and abnormal coloration were evident in the CSF of most cases of CNS bacterial infection, such as meningoencephalitis, meningitis, abscesses, myelitis, and a case of conidiobolomycosis. On the other hand, CSF was unchanged in most cases of toxic disorders, as botulism and hepatic encephalopathy. Elevated CSF density was observed in 60% of ruminants diagnosed with polioencephalomalacia. Our findings show that evaluation of CSF is a valuable diagnostic tool when used in association with epidemiological, clinical and pathological findings for diagnosis of CNS diseases in ruminants.

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Cerebrospinal fluid analysis in infectious diseases of the nervous system: when to ask, what to ask, what to expect

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130153 ◽

2013 ◽

Vol 71 (9B) ◽

pp. 693-698 ◽

Cited By ~ 8

Author(s):

Luis dos Ramos Machado ◽

Jose Antonio Livramento ◽

Liliana Scaff Vianna

Keyword(s):

Cerebrospinal Fluid ◽

Nervous System ◽

Bacterial Meningitis ◽

Infectious Diseases ◽

Acute Bacterial Meningitis ◽

Degenerative Diseases ◽

Cerebrospinal Fluid Analysis ◽

Fluid Analysis ◽

Csf Analysis ◽

The Difference

Cerebrospinal fluid (CSF) analysis very frequently makes the difference to the diagnosis, not only in relation to infections but also in other diseases of the nervous system such as inflammatory, demyelinating, neoplastic and degenerative diseases. The authors review some practical and important features of CSF analysis in infectious diseases of the nervous system, with regard to acute bacterial meningitis, herpetic meningoencephalitis, neurotuberculosis, neurocryptococcosis, neurocysticercosis and neurosyphilis.

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Cerebrospinal fluid analysis

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.15537 ◽

2017 ◽

Vol 65 (3) ◽

pp. 215

Author(s):

Z. S. POLIZOPOULOU (Ζ.Σ. ΠΟΛΥΖΟΠΟΥΛΟΥ)

Keyword(s):

Cerebrospinal Fluid ◽

Diagnostic Imaging ◽

Biochemical Analysis ◽

Neurological Diseases ◽

Systemic Diseases ◽

Cerebrospinal Fluid Analysis ◽

Fluid Analysis ◽

Csf Analysis ◽

Diagnostic Modalities ◽

Complete Blood Counts

The significance of cerebrospinal fluid (CSF) analysis has been compared to that of complete blood counts for systemic diseases. CSF changes generally follow specific patterns depending on the etiopathogenesis (inflammatory, metabolic, neoplastic) of neurological diseases, thus indicating which further diagnostic modalities should be applied. CSF collection requires operator skills and knowledge of sampling indications and contraindications. Analysis includes physical examination (colour, clarity, viscosity), cytological and biochemical analysis, microbiological and immunologic testing. Despite its limitations, CSF analysis is a useful diagnostic tool, in particular when results are interpreted in combination with historical information, clinical examination and the findings of clinicopathological and diagnostic imaging testing.

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