Fungal meningitis typically presents with which CSF profile?

• A. High protein, low glucose, lymphocytic predominance
• B. High protein, high glucose, neutrophilic predominance
• C. Normal protein, normal glucose, lymphocytes
• D. Low protein, low glucose, eosinophils

Answer: (A)

Fungal meningitis tends to produce a subacute inflammatory picture in the CSF, so the profile shows elevated protein from inflammatory exudate and impaired barrier function, decreased glucose because the organisms consume glucose and transport is affected, and a lymphocytic predominance reflecting a more chronic, cell-mediated response. This combination—high protein, low glucose, with mainly lymphocytes—is characteristic of fungal (and many tuberculous) meningitides, contrasting with the neutrophil-dominant, low-glucose pattern of acute bacterial meningitis and the normal glucose with predominantly lymphocytes seen in many viral meningitis cases.