Glucose oxidase sticks and cerebrospinal fluid rhinorrhea

The recognition of cerebrospinal leakage from a fistula is an important consideration for any physician caring for a head-injured population. Several procedures including radiographic, intrathecal dye, nuclear medicine tracer studies, computerized tomography with metrizamide injection, and immunological fixation have been reported to help in the diagnosis. Introduction of glucose oxidase test sticks has been traditionally touted to be a reliable bedside indicator of CSF rhinorrhea; this case study demonstrates a falsely negative result from glucose oxidase sticks.