Meningitis: The Daily PANCE Blueprint
In a patient diagnosed with bacterial meningitis, a lumbar puncture is performed. What changes are typically observed in the levels of WBCs, glucose, and protein in the cerebrospinal fluid (CSF)?
A. Elevated WBCs, Decreased Glucose, Decreased Protein
B. Elevated WBCs, Decreased Glucose, Elevated Protein
C. Decreased WBCs, Elevated Glucose, Decreased Protein
D. Decreased WBCs, Elevated Glucose, Elevated Protein
E. Elevated WBCs, Elevated Glucose, Elevated Protein
Answer and topic summary
The answer is B. Elevated WBCs, Decreased Glucose, Elevated Protein
In bacterial meningitis, there is usually an increase in the number of white blood cells (WBCs) as the body’s immune response attempts to combat the infection. The glucose levels in the CSF are typically decreased, as the bacteria consume glucose. Protein levels are generally elevated due to increased permeability and inflammatory response.
In viral meningitis, the typical findings in cerebrospinal fluid (CSF) after a lumbar puncture would be:
- WBCs: Mildly to moderately elevated, mostly lymphocytes.
- Glucose: Normal or slightly decreased.
- Protein: Normal or slightly elevated.
In fungal meningitis, the cerebrospinal fluid (CSF) findings are often characterized by:
- WBCs: Elevated, predominantly with lymphocytes.
- Glucose: Decreased, often significantly so.
- Protein: Elevated, sometimes substantially.
| WBCs |
Glucose |
Protein |
| Bacterial |
Elevated (mainly neutrophils) |
Decreased |
Elevated |
| Viral |
Elevated (mainly lymphocytes) |
Normal or slightly decreased |
Slightly elevated |
| Fungal |
Elevated (mainly lymphocytes) |
Decreased |
Elevated |
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ ⇒
Also covered as part of the Family Medicine, Emergency Medicine, Internal Medicine, and Pediatric EOR Topic Lists
