By Dr. Hans Wolfgang Kölmel (auth.)
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CSF: 700 cells/mm 3 , 65 mg% protein. (c) Fifteenth day of illness. Fewer transformed lymphocytes. Activated monocytes predominate. CSF: 40 cells/mm 3 , 45 mg% protein. d, e Eosinophils and basophils, a common finding at the onset of lymphocytic meningitis. 50 e a d c 51 8. Tuberculous Meningoencephalitis Prompt diagnosis of tuberculous meningoencephalitis and application of appropriate therapy are usually decisive in the clinical development of this severe illness. All diagnostically useful parameters have to be investigated at the onset of the illness, since bacteriologic evaluation often produces its results too late or produces no results at all.
F) Unusual plasma cell with 6 nuclei. (Aseptic, eosinophilic meningitis after bleeding angioma, Patient 9 years old). 38 disputed , it seems to have special diagnostic value in cases in which the total cell count in the CSF remains normal. Plasma cells are sometimes found in these cases, as are numerous lymphocytes, some of them transformed, at the expense of the monocytic cell types. a b c d e 39 6. 1. Acute Exudation Phase At the onset of bacterial meningitis, the CSF is dominated by the neutrophils, which constitute over 90% of the cells.
One has to distinguish between benign viral involvement of the CNS and other conditions with an encephalitic, sometimes less favorable course. There are no characteristic differences in the cellularity ofthe CSF. Mumps and herpes simplex viruses, as well as the arborviruses, are the chief pathogenic organisms. In acute cases the pleocytosis may exceed I,OOO/mm 3 , and the CSF may appear bloody as a result of the considerable admixture of red blood cells. In general, the pleocytosis declines with an increasingly encephalitic development of the viral disorder, although transformed lymphocytes and plasma cells persist.
Atlas of Cerebrospinal Fluid Cells by Dr. Hans Wolfgang Kölmel (auth.)