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Cerebrospinal Fluid Cell Differential (Qualitative)

Published: August 9, 2026Updated: August 16, 2026

This test examines the types and proportions of cells found in your cerebrospinal fluid (CSF), which surrounds your brain and spinal cord. It helps identify infections, inflammation, or other conditions affecting the central nervous system.

Quick summary

["This test helps diagnose or monitor conditions like meningitis, multiple sclerosis, or other neurological issues by checking for abnormal cell counts in CSF."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
10563-5
Short code
SEMSRC
Synonyms
Cells Other # Smn
Category
chemistry
Sample
serum
Container
Sterile, wide-mouthed, non-toxic plastic specimen container; glass containers with potential chemical residue should be avoided
Units
N/A
Ref low
0
Ref high
5000000
Fasting
false
Population
adult
Sex
male
Age range
18–99 years
Method
Manual microscopic examination with improved Neubauer hemocytometer counting chamber; wet-mount preparation examined under phase-contrast microscopy at 200-400x magnification
CPT
89325
SNOMED
271961003
Specimen volume
Entire ejaculate (typically 1.5-5 mL); minimum 1 mL recommended for accurate analysis
Stability
Specimen must be analyzed within 1 hour of collection when kept at 20-37°C. If delayed, specimen may be preserved but results should be interpreted with caution.
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
1–4 hours
Order
routine

Why This Test Is Done

Your doctor may order this test if you have symptoms like severe headaches, neck stiffness, fever, confusion, or neurological problems. It’s also used to check for conditions like meningitis, brain tumors, or multiple sclerosis before or after treatment begins.

What to Expect Before the Test

You’ll lie on your back with your head tilted back. A needle will be inserted into your spine to collect a small amount of CSF. The procedure is quick and usually painless, though you may feel a slight pinch. You’ll be asked to lie still afterward to prevent bleeding.

What the Test Results Mean

The results show the types of cells (e.g., white blood cells, red blood cells, or other cells like lymphocytes) and their proportions in the CSF. High white blood cell counts often suggest infection or inflammation, while red blood cells may indicate bleeding.

Common Conditions This Test Helps Diagnose

This test can help diagnose infections like bacterial or viral meningitis, autoimmune diseases like multiple sclerosis, bleeding in the brain, or other neurological disorders. It’s also used to monitor treatment progress or rule out complications.

Reference range

Normally <5 million/mL non-sperm cells (round cells, epithelial cells, leukocytes). Round cells should be <2.5 million/mL. Leukocytes should be <1 million/mL per WHO 2021 (6th edition) criteria.N/A

Specimen: serum

Patient should abstain from ejaculation for 2-7 days prior to specimen collection. Specimen should be collected by masturbation into a sterile, wide-mouthed container. Avoid use of lubricants or condoms containing spermicidal agents.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance: How Results Impact Care

Short name

CSF Cell Count (Qualitative)

Frequently asked questions

What causes elevated or abnormal cell counts in CSF?
Elevated white blood cells (especially lymphocytes) are most commonly seen in infections (e.g., meningitis), autoimmune diseases (e.g., multiple sclerosis), or inflammatory conditions. Red blood cells may indicate bleeding, trauma, or other bleeding disorders. Your doctor will correlate results with symptoms and other tests for a full diagnosis.
How long does it take to get results from this test?
Results are typically available within 1–2 business days. If your doctor suspects a serious condition, they may request urgent follow-up or additional tests.
Can I eat or drink before this test?
You can eat and drink normally before the test, as it doesn’t require fasting. However, inform your doctor if you’re on blood thinners or have a history of bleeding disorders, as this may affect the procedure.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy