1. Mary Howard, age 5, is admitted to the pediatrics ward with a temperature of 105%F, lethargy, and cervical rigidity. A lumbar spinal tap is performed, and three tubes of cloudy CSF are delivered to the laboratory. Preliminary test results are as follows:

Appearance: Cloudy

WBC count: 800 cells/µ L

Differential: 80%

lymphocytes, 15%

monocytes, 5%

neutrophils Protein: 65 mg/dL

Glucose: 70 mg/dL

Gram stain: No organisms seen

a. From these results, what preliminary diagnosis could the physician consider?

b. Is the Gram stain result of particular significance? Why or why not?

c. Are the lymphocytes significant? Why or why not?

d. Would a CSF lactate test be of any value for the diagnosis? Why or why not?