ABSTRACT
Over a thirteen months period, 456 patients clinically suspected of having bacterial meningitis were investigated. Cerebrospinal fluid [CSF] specimens were examined by Gram's stain, white cell [WBC] counts and culture techniques. Gram's stain and cultures of CSF [232] with a cell count of less than 10 cells/mm[3] were consistently negative. However, of the CSF specimens [88] with cell counts greater than l00/mm[3], 28 [6.7%] and 23 [5.2%] of the specimens were positive by cultures and Gram's stain respectively. A total of 31 isolates were identified by culture. Streptococcus pneumoniae [22.4%], Escherichia coli [16%], and Coagulase negative Staphylococci [16%] were the predominant organisms, followed by Haemophilus influenzae [6.4%] and Neisseria men ingitidis [2.6%]. Thus it was concluded that Gram's stain and perhaps culture of CSF with cell counts of less than l0/mm[3] are of no practical diagnostic significance and may be eliminated as routine procedures. The gold standard for the diagnosis of bacterial meningitis is raised WBC cell count [>100/mm[3]], positive Gram's smear and/ or culture of CSF specimen