Correlation of Gram's Stain, Cellular Response and Bacterial Culture of Cerebrospinal Fluids

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Abstract
Over an eight-year period, 4,677 cerebrospinal fluid (CSF) specimens were examined by Gram's stain, culture and white blood cell count, as well as for chemical constituents. The Gram's stain was consistently negative on those CSFs (4,213) with a cell count of less than 100/mm3, and only two of these specimens had a positive culture. Of those specimens with a cell count greater than 100/mm3 (464), however, 9.5% and 7.8% of the specimens were positive by culture and Gram's stain, respectively. Of those CSFs with positive cultures, the Gram's stain was also positive in 81 % of the specimens. These data suggest that Gram's stain and perhaps culture of CSFs with cell counts of less than 10/mm3 are of no practical diagnostic significance and may be eliminated as routine procedures.

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