Instructor's Notes

Interpretation: As we see from the tests above, the patient has an infection of the brain and meninges referred to as meningitis. The blood white cell count is elevated due to the body's response against the bacterial infection.  Analysis of the spinal fluid shows the presence of gram negative, diplococcoid bacteria (Gram stain) and a moderate to high elevation of the number and type of cells in the spinal fluid clearly indicate a bacterial meningitis. Consistent with the findings are decreased glucose and elevated protein levels in the fluid. The bacteria utilize the CSF glucose causing levels to be decreased.  Protein is elevated due to increased cellular matter.  Fortunately, the intracranial pressure was only slightly elevated since the higher the pressure, the greater risk of damage to brain and possibility of seizures.  Values above 300-600 mm are dangerously high.  In addition to the potential damage to the brain and meninges by the invading bacteria, there is also the danger of disseminated intravascular coagulation (DIC).  Since this is a complex and life-threatening medical condition, blood tests were ordered to assess the risk of DIC in this patient. Essentially, DIC is a complex systemic series of events that leads to widespread bleeding into tissues and organs. Our patient had early DIC as evidenced by the petichial rash.  Since early diagnosis and treatment were made, the condition was brought under control early. If you wish to learn more about DIC, there are a few links listed under Additional Links.