How do I interpret WBCs in a traumatic tap?
Predicted CSF WBC per microL = CSF RBC x (peripheral blood WBC/peripheral blood RBC)
How do I interpret protein in a traumatic tap?
- CSF bleeding results in approx. 1 extra mg of protein/dL per 1000 RBCs/microL
How do I tell the difference between viral and bacterial meningitis again?
| Viral Meningitis | Bacterial Meningitis | |
| CSF WBC (per microL) | LOW Usually<250, almost always <2000 | HIGH >1000 |
| Differential | Lymphocytic (but may have early neutrophilic predominance) | Neutrophilic |
| CSF Protein (mg/dL) | LOW <150 | HIGH >250 |
| CSF glucose (mg/dL) | HIGH Usually >50% of serum glu | LOW <45 |
Do I need to take chemoprophylaxis for meningitis exposure?
- NOT indicated for brief healthcare interactions in the ED (<8 hours) unless DIRECT EXPOSURE TO RESPIRATORY SECRETIONS (as with suctioning or intubation).
Crap. I messily intubated a patient with bacterial meningitis. What do I take for prophylaxis??
- Ciprofloxacin 500 mg PO x 1
- Ceftriaxone 250 mg IM x 1
- Rifampin 600 mg PO q12 x 2 days
Reference: UpToDate.
