Why the glucose and protein levels differ between bacterial and viral meningitis? - USMLE Forums
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Old 03-07-2011
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Neuro Why the glucose and protein levels differ between bacterial and viral meningitis?

1) What causes the difference in levels of GLUCOSE and PROTEINS in "bacterial meningitis vs viral meningitis" ?
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Old 03-07-2011
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Inflammation due to any cause will result in inc. proteins in CSF.
Bacteria can utilize glucose so there is dec. in glucose.
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Old 03-07-2011
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Thanks doc ...i still dont get why viral meningitis won't cause a decrease in glucose or a marked increase in proteins ?
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Old 03-07-2011
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As doc_study said, the bacteria (or fungus) would be eating the glucose for energy, and the virus wouldn't, so the glucose would be low in bacterial or fungal meningitis but normal in viral meningitis - this is one of the key diagnostic features of the CSF tap.

Protein could be normal or elevated in viral meningitis. As doc_study said, inflammation will raise levels. Protein will especially be raised in bacterial or fungal meningitis - I think of it as the presence of antibodies, though I'm not sure if that's accurate.

hope that helped a little...
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Old 03-07-2011
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It's also beneficial to look at differential counts, it varies widely between the two to help diagnosis!

Ex. Bacterial, its PMN's usually more than 300/mm^3
Viral, its Mono, less than 300/mm^3
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Old 03-07-2011
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And as patelMD, pointed out the Bacterial meningitis would cause a non specific acute Inflammatory response. May be more protein in the bacterial meningitis is due to more severe inflammation of the meninges, compromising the BBB.

In case of the Viral meningitis, we have a low cell counts because only Lymphocytes are recruited to start a Cell mediated response.

Glucose is consumed by both the Bacteria & WBCs. So, more fall in CSF glucose in the Bacterial Meningitis.

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Originally Posted by Mondoshawan View Post
I think of it as the presence of antibodies, though I'm not sure if that's accurate.
I think increased Igs in CSF are seen characteristically in the MS. I have forgotten the specific name of this phenomenon...
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Old 03-07-2011
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Oligoclonal bands!
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Old 03-09-2011
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About increasing CSF proteins in both (viral & bacteal meningitis etc) - additionally don't forget that inflammation causes vessel permeability
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Microbiology-, Nervous-System-, Pathology-

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