Which CSF profile is most consistent with fungal meningitis?

Which CSF profile is most consistent with fungal meningitis?

• A. Increased pressure; Increased lymphocytes; Increased protein; Decreased glucose; Clear to hazy
• B. Normal pressure; Neutrophils predominance; Normal protein; Normal glucose
• C. Decreased pressure; Lymphocytes predominance; Increased protein; Increased glucose
• D. Increased pressure; Eosinophils; Decreased protein; Increased glucose

Answer: (A)

Fungal meningitis typically presents with a CSF profile of elevated opening pressure, a lymphocytic predominance, higher protein, and lower glucose, with the fluid often described as clear to hazy rather than grossly purulent. The lymphocyte-dominant response reflects the chronic fungal inflammation; increased protein comes from the inflamed, permeable blood-brain barrier; and reduced glucose occurs because fungi and immune cells consume glucose and the inflammatory process impairs glucose transport. This pattern helps distinguish fungal meningitis from bacterial meningitis (neutrophil predominance with very low glucose) and viral meningitis (usually lymphocytes with normal glucose).

Fungal meningitis typically presents with a CSF profile of elevated opening pressure, a lymphocytic predominance, higher protein, and lower glucose, with the fluid often described as clear to hazy rather than grossly purulent. The lymphocyte-dominant response reflects the chronic fungal inflammation; increased protein comes from the inflamed, permeable blood-brain barrier; and reduced glucose occurs because fungi and immune cells consume glucose and the inflammatory process impairs glucose transport. This pattern helps distinguish fungal meningitis from bacterial meningitis (neutrophil predominance with very low glucose) and viral meningitis (usually lymphocytes with normal glucose).