CSF findings in a patient with chronic meningitis are: clear appearance, lymphocytic pleocytosis of 60 cells/uL, protein 250 mg/dL, glucose 25 mg/dL (simultaneous serum glucose 90 mg/dL), and opening pressure elevated. Which etiology best fits this profile?

• A Enteroviral meningitis
• B Herpes simplex virus type 2 meningitis
• C Streptococcus pneumoniae meningitis
• D Tuberculous meningitis ✓

Explanation

Lymphocytic pleocytosis with markedly elevated protein, very low glucose, and raised pressure is the classic tuberculous meningitis CSF profile; the low glucose reflects active meningeal inflammation with impaired transport. Viral meningitis typically has near-normal glucose and modestly raised protein. Pyogenic bacterial meningitis shows neutrophilic pleocytosis with very low glucose rather than lymphocytes.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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