A CSF is equally bloody in all tubes collected and has a yellowish supernatant. On the differential, macrophages with hemosiderin are noted. Which of the following is most likely?
a. Bacterial meningitis
b. Viral meningitis
c. Subarachnoid hemorrhage
d. Traumatic tap
ANS: C
Because all tubes were equally bloody, it indicates hemorrhage. If it had been a traumatic tap, then there should have been a gradual decrease in the number of red cells in successive tubes with gradual clearing. The yellow tinge to the supernatant suggests a subarachnoid hemorrhage.
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