Gram – CSF: 3+ (6-10/oif) neutrophils –3+ (11-50/oif) gram negative diplococci/cocci  – Shipped February 08, 2021


A simulated CSF sample collected from 18 year old student was sent to category A, and C1 laboratories. Participants were expected to report the presence of gram negative diplococci/cocci.


  1. Meningitis in a young adult, especially student, is most commonly caused by Neisseria meningitidis.
  2. An urgent cerebrospinal fluid collected in the emergency room should be examined rapidly in the microbiology lab to confirm what most likely will be either consistent with meningococcal meningitis (with many neutrophils and gram negative diplococci/cocci), or viral (with a lymphocytosis and no bacteria observed).
  3. Microbiology laboratories should confer with their chemistry (low glucose) and hematology ( a significant neutrophil response) colleagues to confirm the bacterial nature of the infection.

Full critique (PDF)

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