Table 1.
Serial CSF examination in the patient
| Parameter | May 2017* | August 2017 | September 2018 | November 2018 | January 2019 | March 2019 |
|---|---|---|---|---|---|---|
| Cell count (per mm3) | 102 | 115 | 350 | 140 | 1,000 | 120 |
| Cell type | L: 70% and P: 30% | L: 70%, P: 29%, and degenerated cells: 1% | L: 80% and P: 20% | L: 70% and P: 30% | L: 20% and P: 80% | L: 20%, P: 70%, and degenerated cells: 5% |
| Protein (mg/dL) | 74 | 47 | 155 | 105 | 338 | 177 |
| Glucose (mg/dL) | 42 | 47 | 73 | 175 | 297 | 216 |
| Chloride (mmol/L) | NA | NA | 120 | 119 | 114 | 119 |
| CSF lactate (mg/dL) | NA | NA | NA | 28 | NA | NA |
| Cartridge-based nucleic acid amplification test | – | – | – | Negative | – | Negative |
| Acid-fast bacilli culture | – | No growth | No growth | – | – | No growth |
| India ink | NA | Negative | Negative | NA | NA | Negative |
| Cryptococcal capsular polysaccharide antigen by latex agglutination test | – | – | Negative | – | – | – |
| Fungal PCR | – | – | – | – | – | Positive |
| Fungal culture | – | – | – | – | – | No growth |
| Cytospin for malignant cells | – | Transformed lymphocytes, reactive monocytes, RBCs, and few polymorphonuclear cells | Transformed lymphocytes, few reactive monocytes, polymorphonuclear cells, and RBCs | Predominantly transformed lymphocytes, few reactive monocytes, and polymorphonuclear cells | Predominantly polymorphonuclear cells, few lymphocytes, occasional reactive monocytes, eosinophils, and plasmacytoid cells | Inflammatory smear with numerous degenerating polymorphonuclear and few reactive lymphocytes, and monocytoid cells. No malignant cells |
CSF = cerebrospinal fluid; L = lymphocyte; NA = not available; P = polymorph; RBC = red blood cells.
*
Cerebrospinal fluid analysis was carried out at another center.