What makes csf cloudy

The second reason for CSF discoloration is due to red cells and their breakdown products. After the blood has been in the CSF for greater than 12 hours, the red cells begin to lyse in large quantities and the oxyhemoglobin and bilirubin cause a yellow orange discoloration of the CSF.

This orange red discoloration is known as xanthochromia and can be measured in the lab by spectrographic analysis. The presence of xanthochromia is always pathological. Levels higher than this suggests either SAH, intracranial bleed or traumatic tap.

A traumatic tap occurs when the LP needle enters a blood vessel while performing the procedure. Traumatic taps commonly occur when the needle has advanced slightly too far and transfixed the internal vertebral plexus the more densely packed area of vasculature on the ventral side of the spinal cord.

Differentiating between traumatic tap and SAH is usually fairly easy. If you suspect a traumatic tap, order cell counts on test tubes one and three. Also have the lab examine the CSF for xanthochromia.

Because the traumatic tap is acute, there should be no xanthochromia. The presence of xanthochromia suggests there has been previous CSF bleeding. Typical clinical features of viral meningitis include:. Further investigations to assist in the diagnosis of viral meningitis include:.

Typical clinical features of fungal meningitis include:. Further investigations to assist in the diagnosis of fungal meningitis include:. Typical clinical features of tuberculosis meningitis include:.

Further investigations to assist in the diagnosis of tuberculosis meningitis include:. Typical clinical features of subarachnoid haemorrhage include:. Further investigations to assist in the diagnosis of subarachnoid haemorrhage include:. Typical clinical features of Guillain Barre syndrome include:.

Further investigations to assist in the diagnosis of Guillain Barre syndrome include:. Typical clinical features of multiple sclerosis include:. Further investigations to assist in the diagnosis of multiple sclerosis include:.

A year-old woman has become increasingly more confused over the last 2 months. Over the last 3 days, she has been vomiting and suffering from lack of energy. The most likely diagnosis is fungal meningitis , in this particular case this lady is found to have cryptococcal meningitis on CSF culture.

A year-old male presents with a hour history of high fever, severe headache, confusion, photophobia and neck stiffness. He has no significant past medical history and takes no regular medication. The most likely diagnosis is bacterial meningitis. This young gentleman has presented with meningeal symptoms, fever and confusion which have progressed rapidly over the last 12 hours. A spinal tap may also be done to establish the diagnosis of normal pressure hydrocephalus or bleeding into the spinal fluid from an aneurysm.

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results. The examples above show the common measurements for results for these tests.

Some laboratories use different measurements or may test different specimens. If the CSF looks cloudy, it could mean there is an infection or a buildup of white blood cells or protein. If the CSF looks bloody or red, it may be a sign of bleeding or spinal cord obstruction. If it is brown, orange, or yellow, it may be a sign of increased CSF protein or previous bleeding more than 3 days ago.

There may be blood in the sample that came from the spinal tap itself. This makes it harder to interpret the test results. Brain herniation may occur if this test is done on a person with a mass in the brain such as a tumor or abscess. This can result in brain damage or death. This test is not done if an exam or test reveals signs of a brain mass. Damage to the nerves in the spinal cord may occur, particularly if the person moves during the test.

Cisternal puncture or ventricular puncture carries additional risks of brain or spinal cord damage and bleeding within the brain. Spinal tap; Ventricular puncture; Lumbar puncture; Cisternal puncture; Cerebrospinal fluid culture. Approach to the patient with neurologic disease. Goldman-Cecil Medicine. Philadelphia, PA: Elsevier; chap Euerle BD.

Spinal puncture and cerebrospinal fluid examination. Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. Bradley and Daroff's Neurology in Clinical Practice. We use cookies to ensure you get the best experience from our website. By using the website or clicking OK we will assume you are happy to receive all cookies from us.

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Cerebrospinal Fluid CSF is normally sterile, colorless, and clear.