DANIEL M. MUSHER, M.D.; RONALD F. SCHELL, PH.D.
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To the editor: Interpretation of the Gram stain of cerebrospinal fluid in meningitis frequently determines the initial choice of antibiotics. Even when properly done, a Gram stain may give misleading information of two kinds:  it may not show bacteria in the cerebrospinal fluid of a patient with documented bacterial meningitis (false-negative); or  it may show microorganisms that were not in the cerebrospinal fluid—these "false-positives" have received less attention in the clinical literature. Table 1 summarizes data on four cases of meningitis in which a false-positive Gram stain caused confusion early in treatment. We also report observations on the
MUSHER DM, SCHELL RF. False-Positive Gram Stains of Cerebrospinal Fluid. Ann Intern Med. ;79:603–604. doi: 10.7326/0003-4819-79-4-603
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Published: Ann Intern Med. 1973;79(4):603-604.
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