The common symptoms of meningitis are severe headache, stiff neck, high fever and altered mental status. When a patient has developed these symptoms and he is suspected to have meningitis, blood tests are required to be conducted to identify the cause of inflammation. The cause can be viral or bacteria or it could be other reasons too.
The most important test used to diagnose meningitis is the analysis of the cerebrospinal fluid through lumbar puncture (LP, spinal tap). If a patient is at risk for carrying out this test due to head injury etc., a CT or MRI scan is conducted.
During the lumber puncture procedure, the opening pressure is measured. A pressure in the range 200mm to 500mm of H2O is indicative of Meningitis. For children the pressure value could be lower. If the color of the fluid is cloudy this is due to high levels of protein, white and red blood cells and also bacteria indicating that it is possibly bacterial meningitis.
Then the cerebrospinal fluid is to be examined for types of white blood cells, red blood cells, protein content and also glucose level. Gram staining of the sample is to be conducted to confirm the presence of the bacteria. The absence of bacteria at this stage does not rule out bacterial meningitis. Microbiological culture of the sample needs to be done to locate the culprit.
There are some more tests such as latex agglutination test, the limulus lysate test and polymerase chain reaction (PCR) for bacterial or viral DNA. These tests are to be conducted on the sample only if Gram stain test and culture have not yielded the desired result.
Since meningitis is a life threatening disease, for initial treatment, one can not wait for the result of the blood test to be available. Broad spectrum antibiotic treatment is started immediately to bring the infection under control.
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