This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (19)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Terry W. Crowson, MD; Eugene C. Rich, MD; Bert F. Woolfrey, MD, PhD; Donald P. Connelly, MD, PhD

JAMA. 1984;251(1):70-72.

Abstract
Over a five-year period, 1,883 specimens were cultured for mycobacterium tuberculosis (TB) at our hospital. All cultures were negative, and no cases of tuberculous meningitis were diagnosed. Culture rates (percent of CSF specimens cultured for TB) varied from 74% on the Medicine and Neurology services to 6% on the Pediatric service. These culture rates have been stable for five years. These data suggest that on the Medicine and Neurology services, TB cultures of CSF are persistently overutilized. A simple rule of not culturing CSF for TB if results of the CSF analysis are normal (ie, WBC count 4/cu mm, protein level 45 mg/dL, and glucose level 45 mg/dL) could reduce utilization by at least 50% without adversely affecting quality of care.

(JAMA 1984;251:70-72)

Author Affiliations
From the Section of General Internal Medicine, Department of Medicine (Drs Crowson and Rich) and the Clinical Microbiology Section, Department of Anatomic and Clinical Pathology (Dr Woolfrey), St Paul-Ramsey Medical Center; and the Departments of Medicine (Drs Crowson and Rich) and Laboratory of Medicine and Pathology (Drs Woolfrey and Connelly), University of Minnesota Medical School, St Paul.

Footnotes
Reprint requests to St Paul-Ramsey Medical Center, 640 Jackson St, St Paul, MN 55101 (Dr Crowson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Do We Know What Inappropriate Laboratory Utilization Is?: A Systematic Review of Laboratory Clinical Audits
van Walraven and Naylor
JAMA 1998;280:550-558.
ABSTRACT | FULL TEXT  

The Spinal Tap: A New Look at an Old Test
MARTON and GEAN
ANN INTERN MED 1986;104:840-848.
ABSTRACT  

The Diagnostic Spinal Tap
ANN INTERN MED 1986;104:880-885.
ABSTRACT  

Inappropriate Use of the Cerebrospinal Fluid Venereal Disease Research Laboratory (VDRL) Test to Exclude Neurosyphilis
DANS et al.
ANN INTERN MED 1986;104:86-89.
ABSTRACT  

Excessive Mycobacterial Cultures
Geiseler and Snukst
JAMA 1984;252:2957-2957.
ABSTRACT