Characteristics of Cerebrospinal Fluid in Tuberculous Meningitis Patients with Hydrocephalus

Astrid Tamara Maajid Budiman, Nida Suryana, Ahmad Faried, Ida Parwati


Objective: To describe cerebrospinal fluid (CSF) characteristics in tuberculous meningitis (TBM) with hydrocephalus patients as diagnostic criteria of TBM.

Methods: A cross-sectional using retrospective method was applied in this study by obtaining medical records of TBM with hydrocephalus patients that were treated at Department of Neurosurgery Dr. Hasan Sadikin General Hospital, Bandung from January 2014–September 2016.

Results: Sixty one records were included in the study. Patient characteristics such as age, gender, and CSF laboratory features such as color and clarity, cells and differential count, protein, and glucose were recorded and descriptively analyzed. The majority of CSF macroscopic appearance was seen to be clear (88%) and colorless (88%). Median for CSF cell count was 25 cells/mm3 with lymphocyte predominance (median: 76%). Increased protein from normal value range was seen in CSF (median: 50 mg/dL) while the mean for CSF glucose in this study remained in its normal value range (mean: 58.9±26.68 mg/dL) with lower CSF to blood glucose ratio (mean: 0.41±0.27).

Conclusions: Clear CSF with colorless appearance, lymphocyte pleocytosis, high protein level, and low CSF glucose as well as blood glucose ratio remain typical CSF characteristics of TBM patients found at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung.

Keywords: Cerebrospinal fluid, hydrocephalus, tuberculous meningitis


DOI: 10.15850/ijihs.v6n2.1129


Cerebrospinal fluid, hydrocephalus, tuberculous meningitis

Full Text:



World Health Organization. Global tuberculosis report 2015. 20th ed. Geneva: World Health Organization, 2015.

Rock RB, Olin M, Baker CA, Molitor TW, Peterson PK. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev. 2008;21(2):243–61.

Marais S, Thwaites G, Schoeman JF, Torok ME, Misra UK, Prasad K, et al. Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis. 2010;10(11):803–12.

Güneş A, Uluca Ü, Aktar F, Konca Ç, Şen V, Ece A, et al. Clinical, radiological and laboratory findings in 185 children with tuberculous meningitis at a single centre and relationship with the stage of the disease. Ital J Pediatr [serial on the internet]. 2015 Oct [cited 2017 Aug 12];41(75):[about 6p.]. Available from:

Pinto VL, Lima MA, Rolla VC, Rebelo MC, Boia MN. Atypical cerebrospinal fluid profile in tuberculous meningitis. Trop Doct. 2009;39(2):76–8.

Shaikh MA, Shah M, Channa F. Criteria indicating morbidity in tuberculous meningitis. J Pak Med Assoc. 2012;62(11):1137–9.

Rajshekhar V. Management of hydrocephalus in patients with tuberculous meningitis. Neurol India. 2009;57(4):368–74.

Karcher DS, McPherson RA. Cerebrospinal, synovial, serous body fluids, and alternative specimens. In: McPherson RA, Pincus MR, editors. Henry’s clinical diagnosis and management by laboratory methods. 22nd ed. Philadelphia: Elsevier Saunders; 2011. p. 480–92.

Qamar FN, Rahman AJ, Iqbal S, Humayun K. Comparison of clinical and CSF profiles in children with tuberculous and pyogenic meningitis; role of CSF protein: glucose ratio as diagnostic marker of tuberculous meningitis. J Pak Med Assoc. 2013;63(2):206–10.

Salekeen S, Mahmood K, Naqvi IH, Baig MY, Akhter ST, Abbasi A. Clinical course, complications and predictors of mortality in patients with tuberculous meningitis--an experience of fifty two cases at Civil Hospital Karachi, Pakistan. J Pak Med Assoc. 2013;63(5):563–7.

Christensen A-SH, Andersen ÅB, Thomsen VØ, Andersen PH, Johansen IS. Tuberculous meningitis in Denmark: a review of 50 cases. BMC Infect Dis. 2011;11(1):1–6.

Solari L, Soto A, Agapito JC, Acurio V, Vargas D, Battaglioli T, et al. The validity of cerebrospinal fluid parameters for the diagnosis of tuberculous meningitis. Int J Infect Dis [serial on the internet]. 2013 Dec [cited 2016 Nov 18];17(12):[about 5p.]. Available from:

Cerebrospinal fluid. In: Strasinger SK, Di Lorenzo MS, editors. Urinalysis and body fluids. 6th ed. Philadelphia: F.A. Davis Company; 2008. p.177–95.

Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect. 2009;59(3):167–87.

Solomons RS, Visser DH, Donald PR, Marais BJ, Schoeman JF, van Furth AM. The diagnostic value of cerebrospinal fluid chemistry results in childhood tuberculous meningitis. Childs Nerv Syst. 2015;31(8):1335–40.

Alfayate-Miguelez S, Martinez-Lage-Azorin L, Marin-Vives L, Garcia-Martinez S, Almagro MJ, Martinez-Lage JF. Normal ventricular-CSF may comfound the diagnosis of tuberculous meningitis hydrocephalus. Neurocirugia (Astur). 2011;22(2):157–61.

Miftode EG, Dorneanu OS, Leca DA, Juganariu G, Teodor A, Hurmuzache M, et al. Tuberculous meningitis in children and adults: a 10-year retrospective comparative analysis. PLoS One. 2015 Jul [cited 2016 Nov 18];10(7):[about 10p.] Available from:

Nigrovic LE, Malley R, Macias CG, Kanegaye JT, Moro-Sutherland DM, Schremmer RD, et al. Effect of antibiotic pretreatment on cerebrospinal fluid profiles of children with bacterial meningitis. Pediatr. 2008;122(4):726-30.

Article Metrics

Abstract view : 8069 times
PDF - 1471 times


This Journal indexed by



Creative Commons License
IJIHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

View My Stats