Which finding in an analysis of cerebrospinal fluid (CSF) is consistent with a diagnosis of bacterial meningitis?

Choice A rationale Cerebrospinal fluid (CSF) appearing cloudy or turbid is highly consistent with bacterial meningitis because the high concentration of white blood cells (pleocytosis), specifically neutrophils, and bacteria present in the CSF cause the fluid to lose its normal clear, colorless appearance. This visual change is a strong immediate indicator of severe infection. Choice B rationale In bacterial meningitis, the large accumulation of exudate, inflammation, and increased vascular permeability within the central nervous system usually leads to increased CSF production and decreased reabsorption, resulting in elevated or increased CSF pressure, not decreased pressure. Decreased pressure is rarely associated with acute bacterial infection. Choice C rationale An analysis consistent with bacterial meningitis typically shows a significantly elevated number of leukocytes (pleocytosis), especially polymorphonuclear neutrophils, reflecting the body's aggressive inflammatory response to the bacterial invasion. Few leukocytes (a normal range is 0-5 mononuclear cells/mm³) would be inconsistent with a bacterial infection. Choice D rationale Bacterial meningitis is characterized by bacteria consuming glucose for energy, leading to a markedly decreased CSF glucose level (hypoglycorrhachia), which is often less than 40 mg/dL or less than two-thirds of the concurrent blood glucose level. An increased glucose level in the CSF is usually not a finding in this condition.