Turbidity

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The page below is a sample from the LabCE course Cerebrospinal Fluid. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Turbidity

Spinal fluid samples can be either clear or turbid. Table 2 lists a rating system for turbid CSF specimens that some sources may use.
Table 2. Quantifying CSF Turbidity.
QuantitationDescription
0 Clear fluid
1+ Faintly cloudy, smoky, or hazy
2+ Turbidity evident but newsprint read easily through the tube
3+Turbid with newsprint not easily read through the tube
4+Turbid with newsprint not able to be seen through the tube
Turbidity may be caused by white blood cells (WBCs), red blood cells (RBCs), fungi, bacteria, amoebae, contrast media, or aspiration of epidural fat during puncture. 200 WBCs/mm3 will cause slight turbidity (1+); increased numbers of WBCs will cause increased turbidity. At least 400 erythrocytes/mm3 are needed to produce 1+ turbidity.
CSF may have an oily appearance due to the presence of substances remaining in the fluid following radiologic (x-ray) procedures.
1. Hassan, Hossam. "Cerebrospinal Fluid." November 8, 2014. Available at: https://www.slideserve.com/leo-murphy/cerebrospinal-fluid-by-hossam-hassan.

CSF turbidity is displayed in the tube on the left with a
normal CSF sample on the right. (1)