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CSF (Bacteriology)

Meningitis is defined as inflammation of the meninges. This process may be acute or chronic and infective or non-infective. Many infective agents have been shown to cause meningitis, including viruses, bacteria, fungi and parasites.

Royal Manchester Children's Hopsital is a specialist paediatric neurology centre; as such CSF obtained from ventricular shunts and shunts removed during revision may also be submitted to the laboratory for microscopy and culture.

General information

Collection container (including preservatives): Collect specimens in appropriate CE marked leak proof containers and transport specimens in sealed plastic bags.

Specimen type: Cerebrospinal Fluid


Collection: Use aseptic technique. Collect specimens into appropriate CE marked leak proof containers and place in sealed plastic bag.

Specimen transport: Specimens should be transported and processed as soon as possible.

Minimum volume of sample: For routine cell count and culture; ideally a minimum volume of 1mL

For Mycobacteria sp., culture (Tb), at least 6mL where possible; such investigations cannot be performed outside of normal hours

CSF is normally collected sequentially into three or more separate containers which should be numbered consecutively.

Special precautions: Always contact the laboratory when sending a CSF sample. Send sample 3 (or the last sample if more than 3 taken) to Microbiology. Outside of normal hours contact the on-call Biomedical Scientist through the main switchboard.

Laboratory information

Measurement units: Cell count x106/L

Biological reference units:


  • Neonates: 0 - 30  cells x 106/L
  • 1-4yr old 0 - 20  cells x 106/L
  • 5yr-puberty 0 - 10  cells x 106/L
  • Adults 0 - 5   cells x 106/L

When possible the WBC count will be differentiated into lymphocytes and polymorphs.


  • Newborn 0 - 675 cells x 106/L
  • Adults 0 - 10  cells x 106/L


Protein (Performed by Biochemistry)

  • Neonate (Up to 7 days): 0.4 to 1.1 g/L
  • 1 to 4 weeks: 0.2 - 0.8 g/L
  • 1 to 3 months: 0.2 - 0.7 g/L
  • 3 months to adult: 0.05 - 0.45 g/L


Glucose (Performed by Biochemistry)

  • 40% - 80% plasma level collected at the same time, generally 3.0 to 6.0mmol/L


Turnaround time: 30 mins to 1 hour for microscopy. 24 hrs - 72 hrs for culture

Clinical information

Clinical decision points: Not applicable

Factors known to significantly affect the results: Cells disintegrate and a delay may produce a cell count that does not reflect the clinical situation of the patient.