Which of the following is not seen in tubercular meningitis:
Correct Answer: Cerebrospinal fluid reveals a low leukocyte count.
Description: Ans. (d) Cerebrospinal fluid reveals a low leukocyte count.Ref : Harrison 19th ed. / 898-99Refer to above table* Tubercular meningitis is seen most often in young children but also develops in adults, especially those infected with HIV.* Tubercular meningitis results from the hematogenous spread of primary or post primary pulmonary TB.* The disease often presents subtly as headache and slight mental changes after a prodrome of weeks of low-grade fever, malaise, anorexia, and irritability.* In general, examination of cerebrospinal fluid (CSF) reveals a high leukocyte count (up to 1000/pL), usually with a predominance of lymphocytes but sometimes with a predominance of neutrophils in the early stage; a protein content of 1-8 g/L (100-800 mg/dL); and a low glucose concentration.* Culture of CSF is diagnostic in up to 80% of cases and remains the gold standard. Polymerase chain reaction has a sensitivity of up to 80%, but rates of false-positivity reach 10%* Imaging studies (CT and MRI) may show hydrocephalus and abnormal enhancement of basal cisterns or ependyma.
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