Diagnosis of the bacteria or fungal meningitis by microscopic examination and Culture with identification and susceptibility test of the isolated organism.
Types of specimen: CSF
Criteria of specimen rejection
Non sterile container
Infection of C.S.F
CSF is a sterile Fluid and does not contain any commensals, however, care should be taken not to contaminate the specimen with skin normal flora during collection
Common bacterial pathogen
Haemophilus influenzae
Neisseria meningitis
Streptococcus pneumoniae
Group A and B streptococci
Gram negative bacilli
Listeria monocytogenes
Treponema pallidum (rare)
Brucella (rare)
Salmonella (rare)
Toxoplsma (rare)
Microbes that cause chronic meningitis
M. tuberculosis
Cryptococcus neoformans
Coccidoides immitis
Histoplasma capsulatum
Blastomyces dermatitides
Candida spp.
Nocardia
Actinomyces
Quantity of specimen: 3 ml of CSF is sufficient for culture
Time relapse before processing the sample
CSF is an emergency specimen and should be processed immediately
Storage: Room Temperature
Specimen processing
Media
2 Blood Agar
Chocolate Agar
MacConkey Agar
Fluid Thioglycollate
Culturing procedure
As a general rule in CSF and body fluid specimens for culture, centrifuge clear specimen and inoculate plates and do staining from sediments. While turbid specimens may not be centrifuged.
Post specimen processing
Interfering factors
- Patient on antibiotic therapy.
- Improper sample collection.
Result reporting
Results of the microscopy and all positive cultures of CSF are reported immediately to the treating physician. Negative bacterial results are sent out 72 hours after the CSF is received.
Turnaround time
Gram stain result is reported within 30 minutes of specimen receipt
- Positive Culture results = 3- 5 days
- Negative Culture results = 2-3 days
Additional information
Several antigen detection methods are available for the direct detection of the polysaccharide capsular antigen of H. influenzae, N. meningitidis, S. pneumoniae and Group B streptococci in CSF which showed specificity and sensitivity of about 90-97%. Direct detection of Cryptococcus antigen in CSF is also available which replaced India ink in many laboratories. The routine culture for CSF does not include all organisms mentioned in the above
