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Investigating possible central nervous system infection
Cerebrospinal fluid (CSF) is secreted by the choroid plexuses, around the cerebral vessels, and along the walls of the ventricles of the brain, filling the ventricles and cisternae and bathing the spinal cord. CSF is reabsorbed into the blood through the arachnoid villi. CSF turnover is rapid, exchanging about 4 times per day.
CSF glucose levels may be decreased due to consumption by microorganisms, impaired glucose transport, or increased glycolysis. Elevated CSF glucose levels are consistent with hyperglycemia.
Spinal fluid glucose concentration should be approximately 60% of the plasma/serum concentration and should be compared with concurrently measured plasma/serum glucose for adequate clinical interpretation.
Cerebrospinal fluid (CSF) glucose levels may be decreased in any central nervous system infection, although levels are typically normal in viral meningitis, low in bacterial meningitis, and may be normal or low in fungal meningitis.
CSF glucose levels are normally about 60% of blood glucose levels.
Handle specimens in stoppered containers to avoid contamination and evaporation.
Cerebrospinal fluid specimens should be processed without delay; they may contain cellular constituents, as well as organisms, that lower the concentration of glucose with time.
Processed specimens can be stored at 2 to 8 degrees C for up to 7 days.
Tietz Textbook of Clinical Chemistry. Fourth edition. Edited by CA Burtis, ER Ashwood, D Burns. Philadelphia, WB Saunders Company, 2006 pp 837-891