Symptoms Acute /subacuteChronic LocalizedDiffuse SingleMultiple StaticProgressive ConstantIntermittent Single EpisodeRecurrent AbruptGradual SevereMild PainfulNonpainful BiliousNonbilious Sharp/StabbingDull/Vague Problem Characteristics Ill-appearing/ Toxic Well-appearing/ Non-toxic Localized problem Systemic problem AcquiredCongenital New problem Recurrence of old problem

VirusesBacteriaFungiParasites Enteroviruses (Polio, Echo, Coxsackie) Borrelia burgdorferi** CryptococcusTaenia solium Herpes viruses Mycobacterium TB** CoccidiodesTrichinella spiralis Arboviruses (EEE, WEE, St. Louis, La Crosse, West Nile) BartonellaHistoplasmaToxoplasma gondii MumpsSyphilisBlastomyces HIVBrucellaCandida RespiratoryMycoplasmaAspergillus MeaslesRickettsiaSporothrix schenckii

DrugsMalignancyAutoimmuneOther IbuprofenLymphomaSarcoidEpidermoid cyst BactrimLeukemiaBehcet’s diseasePostvaccination NSAIDSSLEHeavy metals PyridiumKawasakiICH Anti-CD3 monoclonal antibody Partially treated common pathogen bacterial meningitis IVIGParameningeal focus Azathiprine

Glucose (mg/dL) Protein (mg/dL) WBC (cells/µL) DiffGram stain Healthy newborn < 30No PMNsNegative Healthy child < 10No PMNsNegative Bacterial meningitis < 1/2 serum, often < 10 > 100> 1000>50% PMNs, often >90% Positive in 60-80% Enteroviral meningitis Normal , often < 100 >50%PMNs early <50%PMNs late Negative Fungal Meningitis < 1/2 serum> Lymphocyte predominant +/-hyphae TB meningitis< 1/2 serum, often < 10 > Lymphocyte predominant Negative