|A.||High protein content and polymorphous nuclear cells in the CSF|
AFB positive bacilli in CSF
PCR positive for Herpes
Normal CSF analysis
Ans. A. High protein content and polymorphous nuclear cells in the CSF
Acute onset high-grade fever and altered sensorium in the backdrop of a chronic suppurative otitis media makes bacterial meningoencephalitis much likely.CSF studies suggestive of high neutrophils, low sugar, and high protein along with neuroimaging can confirm the diagnosis. A broad-spectrum antibiotic with good CNS penetration must be chosen (as a third-gen cephalosporin) along with steroid ( usually dexamethasone) to prevent complication like SNHL especially with a suspected H.inluenza infection
In neuro-tuberculosis ( AFB +ve in CSF ), there will usually be a subacute or chronic history of symptoms with progression.
Herpes encephalitis would have red blood cells and lymphocytic infiltrates on the CSF analysis.