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The page below is a sample from the LabCE course Reading and Reporting Gram Stained Direct Smears. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Cerebrospinal Fluid and Specimens Collected from Other Sterile Sites

Cerebrospinal fluid (CSF) and all specimens collected from sterile sites should have a microscopic examination performed along with culture. Bacteria found in CSF, blood, tissue, and specimens from other sterile sites are always significant.

CSF should be cytospun, if possible, to increase the chance of detecting a pathogen. The quantity of organisms seen and the amount and type of host cells, e.g., mononuclear or polymorphonuclear (PMN) white blood cells, is important to report. The presence of PMNs indicates bacterial infection. It is also important to determine and report whether the bacteria are found inside or outside of white blood cells.