Correct!
4. 1 and 3

CT scan is usually performed prior to lumbar puncture to identify any lesions which might result in brainstem herniation from lumbar puncture (3). His CT scan was unremarkable and lumbar puncture was performed revealing cloudy fluid with a pink tinge.

CSF analysis demonstrated:

• WBC of 88 cells/mm3
• 91% neutrophils
• 7% lymphocytes
• 2% monocytes
• RBC count 79 mm3
• Glucose of <1 mg/dL
• Protein of 334 mg/dL

What are the leading differential diagnoses for CSF glucose < 1 mg/dL? (Click on the correct answer to be directed to the fourth of seven pages)

1. Carcinomatous meningitis
2. Herpes simplex
3. Pneumococcus
4. 1 and 3
5. All of the above

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