Cerebrospinal Fluid Analysis

A is started on empiric antibiotics for suspected bacterial meningitis. A lumbar puncture is performed and cerebrospinal fluid (CSF) analysis reveals 0 WBC, protein 45 mg/dL, and a CSF/plasma glucose ratio of 0.6.

Additionally, no organisms are seen on Gram stain and a CSF PCR is negative.

Antibiotics are de-escalated. Is this appropriate?

How did others respond?

Reveal the answer

Best Answer:

Yes

Explanation: The patient's cerobrospinal fluid analysis is not consistent with bacterial meningitis. Empiric antibiotics for suspected bacterial meningitis should be reviewed for discontinuation or de-escalation if CSF analysis and other tests are not consistent with bacterial meningitis.