Examination of CSF |
Cell count with differential |
Protein |
Glucose |
Special stains (for specific pathogens, eosinophils) |
Cytology |
Cryptococcal antigen testing |
Cultures (CSF, blood, other fluids where relevant) |
Aerobic and anaerobic bacterial |
Mycobacterial (including acid-fast stains) |
Fungal |
Serologies (blood and/or CSF) |
Fungal serologic tests for Histoplasma, Coccidioides, Sporothrix, Cryptococcus (CF or immunodiffusion) |
Toxoplasma serologies (IFA) |
Antibody tests for HIV-1, HTLV I/II (ELISA, Western blot) |
Cysticercosis serology (EITB) |
Lyme serologies (ELISA, Western blot) |
Syphilis serology (treponemal and nontreponemal tests) |
Brucella serology (standard tube agglutination, CF, ELISA) |
Tularemia serology |
Imaging studies |
Computed tomography (head and chest) |
Magnetic resonance imaging of the head with gadolinium |
Other |
Tuberculin skin test or interferon-gamma release assay |
Serum and CSF 1,3-beta-D-glucan assay |
Meningeal or cortical biopsy (histopathology and culture) |
Bone marrow aspiration and biopsy (with cultures) |
Extractable nuclear antigens, antineutrophil cytoplasmic autoantibodies, and antibodies to cyclic citrullinated peptide |
Erythrocyte sedimentation rate |
Skin or lymph node biopsy, when applicable |
Nucleic acid amplification testing of CSF for Mycobacterium tuberculosis |
CSF PCR for enterovirus |
CSF PCR for Tropheryma whipplei |
CSF metagenomic next-generation sequencing or 16S rRNA sequencing |
Ophthalmologic examination |
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