Dr Mike Bosomworth
Consultant Clinical
Biochemist
>>> "Dr Robert Hill, Consultant Clinical
Chemistry
@KMH"
<
[log in to unmask]> 10/08/2004 16:44:25 >>>
In trying
to put into place the UK NEQAS guidelines for CSF xanthochromia we find
ourselves in competition with our microbiologists for the same third or fourth
sample (to avoid contamination from a bloody tap). It seems that a guideline for
medical staff is required in our hospital whereby the third or fourth CSF
specimen is split into two aliquots - one for meningitis screening, the other
for xanthochromia testing.
The question arises - is it appropriate
to test for meningitis and xanthochromia on all patients with headache from whom
a CSF sample is taken? Although both of these conditions can present with
symptoms of meningeal irritation, does not the presence or absence of fever give
a clue to the more likely diagnosis?
I suppose on the other hand it would be
wrong to let an important diagnostic opportunity slip on a precious
sample.
Any comments?
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