By Dr. Hans Wolfgang Kölmel (auth.)
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Example text
Isolated crystals of hematoidin can sometimes be found in the CSF when the macrophages degenerate. The life span of the phagocytes is relatively long, and they can still be found in the subarachnoid space more than 6 months after the initial hemorrhage. A long life span can be simulated when aging macrophages and their contents are in turn phagocytized by younger cells. Plate 10 a Signet ring cell. Nucleus and phagocytized material displaced to the border of the cytoplasm. b Spinal tap 3 weeks and 2 days after hemorrhage in the subarachnoid space.
The opportunity of demonstrating bacteria in a CSF preparation during the acute infectious stage is often neglected. Even in panoptically stained preparations, pathogenic organisms can be identified in up to 40% of bacterial meningitides, if care is exercised. It is therefore advisable to prepare a Gram stain in addition to the routine method, if bacterial infection is supected. Bacterial culture and the antibiogram are indispensible, as these techniques offer the clinician valuable information about the characteristics of pathogenic organisms.
This condition in chronic meningitis or meningoencephalitis leads one to suspect zoonosis of the CNS. Cysticercosis is the most likely possibility [102, 114,126, 134, 153,210]. A simultaneous increase in the number of eosinophils in the circulating blood does not necessarily accompany the condition. In the CSF, transformed lymphocytes and plasma cells predominate. The cell count can vary between normal values and more than 1,000/mm 3 . •• • • •• • • • •• •• b 35 5. Plasma Cells Plasma cells are present only in pathologically altered CSF.
