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Oxford University Hospitals NHS Foundation Trust

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Cerebro-spinal fluid (CSF) culture

Disease of the central nervous system by infectious agents needs to be diagnosed as quickly as possible to aid correct patient management.

Meningitis is defined as inflammation of the meninges, and may be acute or chronic and infective or non-infective. Many infective agents have been shown to cause meningitis, including bacteria, viruses, fungi and parasites.

Acute bacterial meningitis is a severe and life-threatening disease and the examination of CSF samples is considered a priority. The delay between collection of CSF and examination should be as short as possible.

Examination of CSF may also be relevant in the investigation of other conditions e.g. sub arachnoid haemorrhage.

Specimen requirements

Samples should be transported to the laboratory without delay, either via porter or via the hospital pod system. If specimen transport will be delayed specimens should be stored in a refrigerator until transported to the laboratory.

Cerebro-spinal fluid in plastics sterile universal container. Indicate if the sample is from a lumbar or ventricular puncture, a shunt or a ventricular or lumbar drain.

Any samples requiring CJD studies please call prior to sending the CSF.

Tel: 01865 221918

Laboratory turnaround time

The turnaround time for these samples is up to one day for microscopy and three days for culture.

If the sample is urgent, please alert the laboratory and ask for the microscopy result to be phoned. CSF results are not routinely phoned.

After 12 midnight urgent CSF microscopy is not performed for SCBU 'septic screens' unless a specific indication.

Laboratory method

CSF examination comprises examination of a stained preparation of CSF for the quantification and identification of both white and red blood cells using a C-Chip Fuchs-Rosenthal counting chamber and examination of a Gram stained preparation for the identification of organisms. CSF samples are also cultured onto enrichment agar to encourage the growth of any bacteria.

In specific clinical cases, further investigations may be necessary and should be discussed with the microbiology SpR.

These may include:

  • India ink stain
  • TB stain and culture
  • fungal culture
  • cryptococcal antigen testing
  • PCR for certain viral pathogens.

Where to find results of these tests

  • All results are returned electronically where possible (EPR, SunquestICE).
  • Some results may be phoned to clinicians and GPs.
  • Results are never given directly to patients by the laboratory staff.

Further information and contact details

For further information please email:

Confidential patient information should only be sent from accounts.

Microbiology Laboratory Users Manual (pdf, 684 KB)