Increased leukocytes in cerebrospinal fluid

Introduction Epidemic cerebrospinal meningitis is referred to as epidemic cerebrospinal meningitis. It is a purulent meningitis caused by meningococcus. Clinical manifestations include fever, headache, vomiting, skin and mucous membrane defects, ecchymosis and neck stiffness. The disease was described in 1805 by Vieusseaux, Switzerland. In 1887 Weichselbaum isolated meningococcus from the cerebrospinal fluid. In 1896, Li Tao officially reported in Wuchang.

Cause

Various meningitis, encephalitis: significantly increased in purulent meningitis, up to tens of millions / L (tens of thousands / mm3), mainly neutrophils.

Tuberculous and fungal meningitis also increased, with neutrophils in the early stage and lymphocytes in the late stage.

Viral meningitis generally increases to tens to hundreds, mainly lymphocytes, of which early stage of epidemic encephalitis is mainly neutrophils.

Cerebral hemorrhage or subarachnoid hemorrhage also sees leukocytosis, but it is derived from blood. For example, the number of true white blood cells (the number of white blood cells in the cerebrospinal fluid - the number of red blood cells in the cerebrospinal fluid / 700) is not increased.

Cerebral parasitic diseases or allergic diseases are mainly caused by eosinophils.

an examination

Related inspection

Cerebrospinal fluid cell sorting count cerebrospinal fluid cell count cerebrospinal fluid cell count (CST) cerebrospinal fluid cytology

[normal reference value]

Newborns 15 ~ 20 × 109 / L, June ~ 2 years old 11 ~ 12 × 109 / L.

Adult 4 ~ 10 × 109 / L.

White blood cell classification (adult, %).

Neutral rod-shaped granulocytes 1 to 5.

Neutral lobular granulocytes 50-70.

Eosinophils 0.5 to 5.

Basophils 0 to 1.

Lymphocytes 20 to 40.

Monocytes 3-8.

Differential diagnosis

(A) brain abscess (pyencephalus): blood cells in the acute phase have increased cells, neutrophils up to 10 × 109 / L. The latent blood picture can return to normal or only mild left leukocyte migration. White blood cells rise again when the abscess develops or collapses.

(2) purulent meningitis: the number of white blood cells in the acute phase increases, neutrophils account for 80 to 90%

(C) primary amoebic meningitis (primary amoebic menigoen-cephalitis): white blood cell counts are mostly elevated, neutrophils left shift.

(4) Epidemic encephalitis B: The total number of white blood cells is increased, between (10 ~ 20) × 109 / L, a few can reach more than 30 × 109 / L, mainly due to increased neutrophils, and There is a left shift phenomenon. Eosinophilia is reduced, unlike general viral infections.

(5) Forest encephalitis: The total number of white blood cells is increased to (10-20)×109/L, mainly neutrophils, up to 90%.

(6) Rabies viral encophaliti: The total number of white blood cells increased to (20 ~ 30) × 109 / L, mainly neutrophils.

(7) Cerebral hemorrhage (cerebral hemmorrbage): white blood cells increased, more than 10 × 109 / L accounted for 61 ~ 86.3%. According to statistics, (10 ~ 14) × 109 / L accounted for 27%, (10 ~ 14) × 109 / L accounted for 22%, more than 20 × 109 / L accounted for 12.

(8) Acute disseminated encephalomyelitis: polymyositis, acute myelitis (acutemyelitis) In the acute phase, the number of white blood cells in the peripheral blood is increased.

(9) cystic myosis (cysticerosis myositis), trichinosis myositis: blood eosinophilia.

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