Relevant CBC Results
(Abnormal Results Highlighted in Green)
| CBC Value | Patient | Normal Value * |
|---|---|---|
| White Blood Cell | 24,000 mm3 | 5000-10,000 mm3 |
| Neutrophiles | 87% | 65% |
Spinal Fluid Analysis
(Abnormal Results Highlighted in Green)
| Test Parameter | Patient | Normal Values |
|---|---|---|
| Appearance | Hazy | Clear |
| Glucose | 16 mg/dl | 50-80 mg/dl |
| Total Protein | 88 mg/dl | 15-45 mg/dl |
| White Blood Cells | 2300 mm3 | 0-3 mm3 |
| Cell Differential | 96% neutrophiles | 0-1 neutrophiles |
| Gram Stain | neutrophiles and gram negative diplococci |
no bacteria should be present. CSF is a sterile fluid |
| Intracranial Pressure | 174 mm/H20 | < 140 mm/H20 |
Instructor's Notes:
Interpretation: As we see from the tests above, the patient has an infection of the brain and meninges referred to as meningitis. The blood white cell count is elevated due to the body's response against the bacterial infection. Analysis of the spinal fluid shows the presence of gram-negative, diplococcoid bacteria (Gram stain) and a moderate to the high elevation of the number and type of cells in the spinal fluid clearly indicate bacterial meningitis. Consistent with the findings are decreased glucose and elevated protein levels in the fluid. The bacteria utilize the CSF glucose causing levels to be decreased. Protein is elevated due to increased cellular matter. Fortunately, the intracranial pressure was only slightly elevated since the higher the pressure, the greater the risk of damage to the brain and the possibility of seizures. Values above 300-600 mm are dangerously high. In addition to the potential damage to the brain and meninges by the invading bacteria, there is also the danger of disseminated intravascular coagulation (DIC). Since this is a complex and life-threatening medical condition, blood tests were ordered to assess the risk of DIC in this patient. Essentially, DIC is a complex systemic series of events that lead to widespread bleeding into tissues and organs. Our patient had early DIC as evidenced by the petechial rash. Since early diagnosis and treatment were made, the condition was brought under control early. If you wish to learn more about DIC, there are a few links listed under Additional Links.