Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis

Waleed Bandey; Maryam Zafar; Anam Siddique; Nimrat Ul Ain Banday; Mandar Marathe

doi:10.7759/cureus.97661

Case Report Neurology & Emergency Medicine

Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis

Waleed Bandey, Maryam Zafar, Anam Siddique, Nimrat Ul Ain Banday, Mandar Marathe

Cureus, 17(11), e97661 · 2025 · doi:10.7759/cureus.97661

Plain-language summary

A case report of a 20-year-old woman with meningoencephalitis whose cerebrospinal fluid (CSF) results didn't fit the textbook pattern: blood-tinged fluid (xanthochromia) that could easily be mistaken for a bleed, a near-normal glucose level, and only moderately raised protein — none of which reached the thresholds typically taught for bacterial infection.

Why this matters

Clinicians are often taught to rule meningoencephalitis in or out using CSF threshold values. This case is a caution against over-reliance on those numeric cut-offs — normal glucose or modestly raised protein should not be used to exclude the diagnosis when the clinical picture is suspicious.

Published abstract

Meningoencephalitis is a critical condition that necessitates prompt diagnosis and intervention. This case report underscores the importance of interpreting xanthochromia in cerebrospinal fluid (CSF) in relation to not only vascular pathology but also infectious and inflammatory conditions. Additionally, it is essential to recognize that a normal glucose level should not eliminate the consideration of meningoencephalitis, particularly when there is a strong clinical suspicion. Lastly, it is important to note that a moderately elevated protein level in the CSF can still be consistent with meningoencephalitis, even if it does not reach the threshold typically associated with bacterial infections.

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Keywords

cerebrospinal fluid meningoencephalitis xanthochromia CSF glucose CSF protein

Cite this publication

Bandey W, Zafar M, Siddique A, Banday NUA, Marathe M. Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis. Cureus. 2025;17(11):e97661. doi:10.7759/cureus.97661

Bandey, W., Zafar, M., Siddique, A., Banday, N. U. A., Marathe, M. (2025). Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis. Cureus, 17(11), e97661. https://doi.org/10.7759/cureus.97661

@article{BandeyW2025,
  author = {Waleed Bandey and Maryam Zafar and Anam Siddique and Nimrat Ul Ain Banday and Mandar Marathe},
  title = {Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis},
  journal = {Cureus},
  year = {2025},
  doi = {10.7759/cureus.97661},
  volume = {17},
  number = {11},
  pages = {e97661}
}

TY  - JOUR
AU  - Waleed Bandey
AU  - Maryam Zafar
AU  - Anam Siddique
AU  - Nimrat Ul Ain Banday
AU  - Mandar Marathe
PY  - 2025
TI  - Distinct Cerebrospinal Fluid Findings in a Case of 20-Year-Old Woman Patient With Meningoencephalitis
JO  - Cureus
VL  - 17
IS  - 11
SP  - e97661
DO  - 10.7759/cureus.97661
UR  - https://doi.org/10.7759/cureus.97661
ER  -

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