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CSF Gram Stain

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1. CSF Gram Stain

CSF Gram Stain CSF Gram Stain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 CSF Gram Stain CSF Gram Stain Aka: CSF Gram Stain (...) , Cerebrospinal Fluid Gram Stain , CSF Microscopy II. Test Sensitivity: Gram Stain Factors improving sensitivity Centrifugation Experienced technician Overall Untreated cases: Up to 80% Treated cases: Up to 60% Organism concentration Colony forming units (CFU) <1000/mm3: 25% Colony forming units (CFU) >100,000/mm3: 75% Organism specific : 90% : 50% III. Preparations: Special stains Acid Fast Stain: India Ink: Cryptococcus (tap water control required) Wright or Giemsa stain: Saline mount: Protozoa IV

2018 FP Notebook

2. Gram-Positive Rods on a Cerebrospinal Fluid Gram Stain (PubMed)

Gram-Positive Rods on a Cerebrospinal Fluid Gram Stain Cerebrospinal fluid (CSF) access device placement in the pediatric population presents challenges due to the development of infections following placement, access or revision, and/or shunt malfunctions. Here we report an unusual pediatric case of L. monocytogenes ventriculitis/VP shunt (VPS) infection and associated pseudocyst with an emphasis on the importance of VPS removal in clearing the infection due to biofilm formation.

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2017 Open forum infectious diseases

3. Enhancing pathogen identification in patients with meningitis and a negative Gram stain using the BioFire FilmArray® Meningitis/Encephalitis panel (PubMed)

Enhancing pathogen identification in patients with meningitis and a negative Gram stain using the BioFire FilmArray® Meningitis/Encephalitis panel Meningitis with a negative cerebrospinal (CSF) Gram stain represents a diagnostic and therapeutic challenge. The purpose of our study was to evaluate the performance of the BioFire FilmArray(®) Meningitis/Encephalitis (FA ME) panel in patients presenting with community-acquired meningitis with a negative Gram stain.CSF from 48 patients (...) with community-acquired meningitis with a negative Gram stain admitted to four hospitals in Houston, TX underwent additional testing by the FA ME. FA ME results were compared to results obtained as part of routine evaluation.The panel detected pathogens not previously identified in 11 (22.9 %) of 48, but did not detect pathogens identified by standard technique (West Nile virus, Histoplasma) in 5 (15.2 %) patients.Rapid testing for the most common pathogens causing meningitis will aid in the diagnosis

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2016 Annals of Clinical Microbiology and Antimicrobials

4. Risk Classification for Enteroviral Infection in Children With Meningitis and Negative Gram Stain. (PubMed)

Risk Classification for Enteroviral Infection in Children With Meningitis and Negative Gram Stain. Enterovirus is the most common cause of aseptic meningitis in children. This study aimed at identifying baseline variables associated with a positive cerebrospinal fluid (CSF) Enterovirus polymerase chain reaction (PCR) to aid clinicians in targeting patients who could be tested and treated as outpatients.We performed a retrospective review of children (2 months to 17 years old) admitted (...) to the Children's Memorial Hermann Hospital in Houston, TX, between January 2005 and December 2010 with symptoms of meningitis, CSF white cell count of greater than 5 cells/mm, and a negative CSF Gram stain, who had a CSF Enterovirus PCR.One hundred thirty-seven children were reviewed; median age was 4.7 (0.1-17.1) years, and 79 (58%) were male. Fifty patients (37%) had positive CSF Enterovirus PCR. Only 13 (15%) of the Enterovirus PCR-negative patients had an identifiable etiology. All patients were

2016 Pediatric Emergency Care

5. CSF Gram Stain

CSF Gram Stain CSF Gram Stain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 CSF Gram Stain CSF Gram Stain Aka: CSF Gram Stain (...) , Cerebrospinal Fluid Gram Stain , CSF Microscopy II. Test Sensitivity: Gram Stain Factors improving sensitivity Centrifugation Experienced technician Overall Untreated cases: Up to 80% Treated cases: Up to 60% Organism concentration Colony forming units (CFU) <1000/mm3: 25% Colony forming units (CFU) >100,000/mm3: 75% Organism specific : 90% : 50% III. Preparations: Special stains Acid Fast Stain: India Ink: Cryptococcus (tap water control required) Wright or Giemsa stain: Saline mount: Protozoa IV

2015 FP Notebook

6. Meningitis with a negative cerebrospinal fluid gram stain in adults: risk classification for an adverse clinical outcome (PubMed)

Meningitis with a negative cerebrospinal fluid gram stain in adults: risk classification for an adverse clinical outcome To derive and validate a risk score for an adverse clinical outcome in adults with meningitis and a negative cerebrospinal fluid (CSF) Gram stain.We conducted a retrospective study of 567 adults from Houston, Texas, with meningitis evaluated between January 1, 2005, and January 1, 2010. The patients were divided into derivation (N=292) and validation (N=275) cohorts (...) , multiply by 0.05551). The model classified patients into 2 categories of risk for an adverse clinical outcome--derivation sample: low risk, 0.6% and high risk, 32.8%; P<.001; and validation sample: low risk, 0.5% and high risk, 21.1%; P<.001.Adults with meningitis and a negative CSF Gram stain can be accurately stratified for the risk of an adverse clinical outcome using clinical variables available at presentation.Copyright © 2012 Mayo Foundation for Medical Education and Research. Published

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2013 EvidenceUpdates

7. Open and Exploratory Trial to Investigate the Pharmacokinetic of Ceftobiprole Medocaril in Patients With CSF Device

of an indwelling external CSF access device (ventriculostomy or lumbar drain) Presence of inflamed meninges as a result of documented or suspected meningitis or ventriculitis. Patients with both clinical symptoms (fever, headache, meningismus, and altered mentation) and laboratory parameters (CSF leukocytosis, defined as a CSF white blood cell count [WBC] of >103, elevated CSF protein, defined as CSF protein of >1g/l, reduced CSF glucose, defined as CSF glucose of <0.3g/l, or a positive CSF Gram stain (...) Open and Exploratory Trial to Investigate the Pharmacokinetic of Ceftobiprole Medocaril in Patients With CSF Device Open and Exploratory Trial to Investigate the Pharmacokinetic of Ceftobiprole Medocaril in Patients With CSF Device - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2017 Clinical Trials

8. Role of CSF-CRPand Serum Procalcitonin in Differentiation Between Bacterial and Viral Meningitis in Children

linked immunoassay) using blood culture and gram stain as gold standard test. Study Design Go to Layout table for study information Study Type : Observational Estimated Enrollment : 80 participants Observational Model: Case-Control Time Perspective: Cross-Sectional Official Title: Role of CSF-CRPand Serum Procalcitonin in Differentiation Between Bacterial and Viral Meningitis in Children Estimated Study Start Date : January 1, 2018 Estimated Primary Completion Date : January 1, 2019 Estimated Study (...) and analyzed for serum procalcitonin Outcome Measures Go to Primary Outcome Measures : differentiation between bacterial and viral meningitis [ Time Frame: 12 month ] by using simple bed side diagnostic test as CSF-CRP and procalcitonin confirmed by CSF culture sensitivity and CSF analysis with gram stain Biospecimen Retention: Samples Without DNA CSF analysis with culture sensitivity and gram stain . CSF-CRP level measured by reagent nephelometric method by BN prospec seimense. Serum procalcitonin level

2017 Clinical Trials

9. Accuracy of real-time PCR, Gram stain and culture for Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae meningitis diagnosis. (PubMed)

Accuracy of real-time PCR, Gram stain and culture for Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae meningitis diagnosis. Although cerebrospinal fluid (CSF) culture is the diagnostic reference standard for bacterial meningitis, its sensitivity is limited, particularly when antibiotics were previously administered. CSF Gram staining and real-time PCR are theoretically less affected by antibiotics; however, it is difficult to evaluate these tests with an imperfect (...) reference standard.CSF from patients with suspected meningitis from Salvador, Brazil were tested with culture, Gram stain, and real-time PCR using S. pneumoniae, N. meningitidis, and H. influenzae specific primers and probes. An antibiotic detection disk bioassay was used to test for the presence of antibiotic activity in CSF. The diagnostic accuracy of tests were evaluated using multiple methods, including direct evaluation of Gram stain and real-time PCR against CSF culture, evaluation of real-time

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2013 BMC Infectious Diseases

10. Penetration of Ceftaroline Into Cerebrospinal Fluid(CSF)

(CSF leukocytosis, defined as a CSF white blood cell count [WBC] of >10 3, elevated CSF protein, defined as CSF protein of >1g/l, reduced CSF glucose, defined as CSF glucose of <0.3g/l, or a positive CSF Gram stain or culture) indicative of CNS infection were deemed to have definitive bacterial meningitis/ventriculitis. Inflamed meninges were defined as the presence of >5 leukocytes/mm3 of CSF. Exclusion Criteria: Patient has documented history of hypersensitivity or allergic reaction (urticaria (...) Penetration of Ceftaroline Into Cerebrospinal Fluid(CSF) Penetration of Ceftaroline Into Cerebrospinal Fluid(CSF) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Penetration of Ceftaroline

2016 Clinical Trials

11. Normal CSF: Does it exclude meningitis?

glucose 4.8 mmol), protein 0.6 g/l, white blood cell count 4 with no bacteria on Gram staining. The child was observed with a diagnosis of viral illness without any antibiotics. We wondered: can meningitis occur with initial normal CSF? Search Strategy This review was aimed to obtain all available information with the intention of providing a perspective for resolving this issue. A non-systematic search of the world literature was carried out using English as the main language in July 2008 using (...) results treatment was delayed in all cases. One had high-frequency hearing loss Moore CM et al, 1970, USA n = 4 Age: 4 months – 3 years Case reports Grade 4 Cases of bacterial meningitis with clear CSF Cell count 0–14 cells/mm3Glucose 2.3–4.1 mmol/lProtein 0.09–0.2 g/lGram stain: no bacteria Haemophilus influenzae: 2 Marchantia polymorpha: 1 Streptococcus pneumoniae: 1 Cases were treated as respiratory tract infections. One case had subdural empyema. In two cases LP was repeated and showed purulent

2010 BestBETS

12. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria. (PubMed)

WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four (...) Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria. Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50

2015 Heart & Lung

13. Acute HIV infection presenting as fulminant meningoencephalitis with massive CSF viral replication (PubMed)

dehydrogenase, and 4,600 leukocytes per μL with 61% bands and 18% lymphocytes. Bacterial and fungal blood cultures were negative as well as a rapid HIV test, additional serologies (including rapid plasma reagin and Treponema pallidum particle agglutination), quantitative PCRs (for viruses other than HIV), and urine and blood toxicology. CSF, on hospital day 4, showed a lymphocytic pleocytosis (total leukocytes: 100), high protein, borderline hypoglycorrhachia, and negative Gram stain and culture. Brain MRI (...) Acute HIV infection presenting as fulminant meningoencephalitis with massive CSF viral replication A 22-year-old man presented to the emergency department with 10 days of malaise, generalized rash, sore throat, oral ulcers, headache, nausea, and vomiting. On examination he had fever (101.5°F), hepatosplenomegaly, generalized maculopapular rash, and lymphadenopathy. He rapidly became obtunded, requiring intubation. Initial laboratory studies showed mild transaminitis, increased lactate

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2014 Neurology: Clinical Practice

14. Diagnosis of Tuberculous Meningitis by ESAT-6 in CSF

topics: resources: Groups and Cohorts Go to Group/Cohort ESAT-6 positive ESAT-6 negative Outcome Measures Go to Primary Outcome Measures : the positive percentage of total macrophages [ Time Frame: 2 days ] CSF smears from all patients were prepared and stained by standard immunocytological methods to examine the presence of ESAT-6. These negative controls did not have demonstrable staining (not shown). Positive staining was defined as visualization of yellow brown granules in the cytoplasm (...) Diagnosis of Tuberculous Meningitis by ESAT-6 in CSF Diagnosis of Tuberculous Meningitis by ESAT-6 in CSF - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Diagnosis of Tuberculous Meningitis by ESAT-6 in CSF

2011 Clinical Trials

15. Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay. (PubMed)

Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay. The Limulus amoebocyte lysate endotoxin assay was evaluated as a method for rapid diagnosis of acute bacterial meningitis in a series of 305 patients. The results of Limulus assays on cerebrospinal fluid (CSF) samples from these patients were compared with the results for each patient of routine bacterial cultures and Gram stains. Positive Limulus tests were obtained on initial CSF specimens from 84 (...) % of patients with culture-proven bacterial meningitis, including all patients with meningitis due to gram-negative organisms. Initial Gram-stained smears revealed the presence of organisms in 68% of the patients. One patient with pneumococcal meningitis had a weakly positive Limulus assay, whereas patients with meningitis due to other gram-positive organisms, those with aseptic meningitis, or patients without meningitis had negative CSF Limulus tests. The Limulus assay also demonstrated the persistence

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1978 Journal of clinical microbiology

16. Meningococcal disease

and differential electrolytes, Ca, Mg, glucose coagulation profile (prothrombin time, INR, activated PPT, fibrinogen, fibrin degradation products) cerebrospinal fluid (CSF) Gram stain CSF cell count and differential CSF glucose, protein CSF culture antigen detection in CSF chest x-ray CT head Gram stain of non-CSF body fluid culture of non-CSF body fluid immunohistochemical staining of skin lesion biopsy echocardiography joint x-ray polymerase chain reaction Treatment algorithm INITIAL ACUTE Contributors (...) , and local availability. Case fatality rate is 10% to 15%. Between 10% and 20% of survivors have moderate to severe sequelae, including hearing loss, motor and cognitive disabilities, blindness, or ischaemic injuries of the skin or extremities. Definition Meningococcal infections are caused by Neisseria meningitidis , a gram-negative diplococcus that colonises the nasopharynx. Bacteria invade the bloodstream or spread within the respiratory tract. A case is confirmed by detection of N meningitidis

2018 BMJ Best Practice

17. Listeriosis

Diagnostic investigations FBC urine pregnancy test blood cultures brain MRI brain CT cerebrospinal fluid (CSF) analysis prothrombin time (PT) and PTT D-dimer placenta and amniotic fluid culture cervical swab culture meconium Gram stain and culture Listeria serology food analysis stool culture other stool analyses electroencephalogram echocardiography polymerase chain reaction of blood Treatment algorithm ACUTE Contributors Authors Honorary Clinical Senior Lecturer Glasgow University Consultant in Acute (...) Listeriosis Listeriosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Listeriosis Last reviewed: February 2019 Last updated: November 2018 Summary A gram-positive bacterial infection that affects neonates, pregnant women, adults over 45 to 50 years of age, and immunocompromised people. Mainly a food-borne disease. Prevention consists of hand hygiene, cooking food well, and avoiding unwashed and leftover food

2018 BMJ Best Practice

18. Bacterial meningitis

balance problems/hearing impairment bulging fontanelle in infants high-pitched cry (infants) rash papilloedema Kernig's sign Brudzinski's sign ≤5 or ≥65 years of age crowding exposure to pathogens non-immunised infants immunodeficiency cancer asplenia/hyposplenic state contiguous infection cranial anatomical defects cochlear implants Diagnostic investigations cerebrospinal fluid (CSF) cell count and differential CSF protein CSF glucose CSF Gram stain CSF culture antigen detection in CSF blood culture

2018 BMJ Best Practice

19. Whipple's disease

Whipple's disease Whipple's disease - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Whipple's disease Last reviewed: February 2019 Last updated: March 2018 Summary A chronic multisystemic disease caused by the gram-positive bacterium Tropheryma whipplei , first described by G.H. Whipple in 1907. Affected patients are typically middle-aged white men, who may present with weight loss, arthralgia, diarrhoea, and fever (...) . The infection is very rare, with an estimated incidence of <1/1,000,000, even though T whipplei is ubiquitously present in the environment. Diagnosis is mainly based on duodenal biopsies. Histological findings are characterised by foamy macrophages in the lamina propria that contain large amounts of diastase-resistant periodic acid-Schiff (PAS)-positive particles in the cytoplasm. Polymerase chain reaction (PCR)-based diagnosis can be established from cerebrospinal fluid (CSF) or synovial fluid. Recommended

2018 BMJ Best Practice

20. Labyrinthitis

rotary chair test vestibular-evoked myogenic potentials syphilis serology CSF Gram stain and culture serum HIV rapid test basic metabolic profile (including urea and creatinine) Treatment algorithm ACUTE ONGOING Contributors Authors Associate Professor Department of Otolaryngology-Head & Neck Surgery University of Texas Southwestern Medical Center Dallas TX Disclosures BI is an author of a reference cited in this monograph. Peer reviewers Assistant Professor The Otology Group of Vanderbilt Nashville

2018 BMJ Best Practice

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