Collection,Transportation and Processing of C.S.F

Collection and transportation c.s.f.

The cerebrospinal fluid must be accumulated by an experienced clinical officer or medical expert. It has to be amassed aseptically to save you organisms being brought into CNS . The fluid is usually gathered from the arachnoid space. A sterile extensive-bore needle is inserted among the fourth and 5th lumbar vertebrae and the c.s.f. is authorized to drip right into a dry sterile field. A ventricular puncture is sometimes performed and then done to accumulate c.s.f. from toddlers.

Collection of c.s.f. from patient with suspected trypanosomiasis

whilst the c.s.f. is to be examined for trypanosomes, it is also accrued after remedy to kill the trypanosomes in the blood has been started out. This could avoid the accidental introduction of the parasites into the central nervous system,must the lumbar puncture be traumatic (bloody).

In a hospital with a microbiology laboratory

Note: Advise the laboratory earlier than performing a lumbar puncture so that personnel is organized to acquire and observe the specimen immediately. Be aware: A delay in examining c.s.f. reduces the probabilities of separating a pathogen. it's going to also bring about a lower cellular matter because of WBCs being lyzed, and to a falsely low glucose rate due to glycolysis. While trypanosomes are present, they'll be hard to discover because they are rapidly lyzed once the c.s.f. has been withdrawn.

Collection of c.s.f.

1. Take sterile, dry, screw-capped packing containers and label one No. 1 (first sample accumulated, to be used for culture), and the other No. 2 (second pattern amassed, for use for different investigations).

2. Accumulate approximately 1 ml of c.s.f. in box No. 1 and approximately 2–three ml in container No. 2.

3.Right away deliver the samples with a request form to the laboratory.

In a health centre

Patients with suspected meningitis typically acquire emergency treatment in a health centre and are transferred to the nearest clinic for laboratory investigations and care.

Lab examination OF C.S.F.

Day 1

Note: Cerebrospinal fluid ought to be tested immediately , and the consequences of tests pronounced to the clinical officer as quickly as they grow to be to be had, especially a Gram smear report. The fluid must be handled with special care because a lumbar puncture is needed to acquire the specimen.

1 Record the appearance of the c.s.f.

As quickly as the c.s.f. reaches the laboratory, notice its appearance. document whether or not the fluid:

– is clear, slightly turbid, cloudy or really purulent (searching like pus),

– consists of blood,

– consists of clots.

Regular c.s.f. seems clean and colourless. Purulent or cloudy c.s.f. shows presence of pus cells, suggestive of acute pyogenic bacterial meningitis. Blood in c.s.f. this will be because of a nervous (bloody) lumbar puncture or much less normally to haemorrhage within the significant aapprehensive system While due to a demanding lumbar puncture, sample No. 1 will commonly include more blood than sample No. 2. Following a subarachnoid haemorrhage, the fluid might also seem xanthrochromic, i.e. yellow-red (visible after centrifuging). Clots in c.s.f. Suggests a high protein concentration with extended fibrinogen, as can arise with pyogenic meningitis or whilst there is spinal constriction.

2 Test the c.s.f.

Relying on the arrival of the c.s.f., proceed as follows:

Purulent or cloudy c.s.f.

Suspect pyogenic meningitis and test the c.s.f. as follows:

• Right now make and examine a Gram-stained smear for the micro organism and polymorphonuclear neutrophils (pus cells). Prepare the report right now.
• subculture the c.s.f.

Barely cloudy or clear c.s.f.

Test the c.s.f. as follows:

• Carry out a cell count number and observe whether or not there's an increase in white cells and whether or not the cells are present in particular pus cells

References:

D greenwood, Slack RCB and J Peutherer.Medical microbiology.2001.

JG College, AG Fraser and BP Marmion.Practical Medical microbiology.Fourteenth Edition. Churchill Livingstone, 1996.

JP Micheal, ECS Chan and NR Krieg.Microbiology.Fifth Edition. Delhi: Mcgraw-hill, 1993.

M Cheesbrugh.Medical laboratory manual for tropical countries.London, 2007.