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Updated: Jun 10, 2026

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
Published on: April 17, 2026
A clear CSF is not always a normal CSF: a case report of pneumococcal meningitis
Kirandeep Sodhi1, Kawaljit Singh Multani, Chandrashekhar
1Department of Pediatrics, Command Hospital Air Force, Bangalore, India.
Abstract:
A normal initial cerebrospinal fluid (CSF) study has been traditionally used to exclude the potential diagnosis of bacterial meningitis. However, cases of pyogenic meningitis in the absence of CSF pleocytosis have been reported in which smears for gram stain or CSF culture revealed the diagnosis of meningitis. In the presence of clinical signs of meningitis, an abnormal initial CSF study indicates a diagnosis of bacterial meningitis but a normal result may not necessarily exclude it and therefore, should not delay early institution of appropriate antimicrobial therapy.
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