What does a CSF analysis showing increased WBC count with neutrophil predominance and low glucose indicate in a patient?

Increased white blood cell (WBC) count with neutrophil predominance and low glucose levels in cerebrospinal fluid (CSF) analysis is a classic finding indicative of bacterial meningitis. In cases of bacterial meningitis, the inflammatory response leads to a marked increase in neutrophils, which are the primary cells involved in fighting bacterial infections.

The hallmark feature distinguishing bacterial meningitis from viral infections is the presence of a significantly low glucose concentration in the CSF. Typically, in viral meningitis, the glucose level tends to remain normal, and lymphocytes, rather than neutrophils, are the dominant cell type.

In the context of normal findings, one would expect to see very few WBCs, and glucose levels would be within the normal range, which distinctly contrasts with the profile seen in bacterial meningitis. Autoinflammatory diseases can also alter CSF findings but don’t typically result in such a pronounced neutrophilic response and low glucose levels as seen in bacterial infections.

Thus, the combination of increased WBC count with neutrophil predominance and low glucose is strongly suggestive of bacterial meningitis, highlighting the urgency for prompt diagnosis and treatment.