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Module UBF-09 · Version 1.0

CSF Collection, Processing, and Cell Counts

A low-volume, time-sensitive cerebrospinal fluid (CSF) specimen must be allocated across chemistry, microbiology, and hematology, then examined promptly for a defensible manual cell count. An adult lumbar collection demonstrates receipt, allocation, Fuchs-Rosenthal chamber setup, duplicate-side counting, calculation, and the reporting limits for a traumatic or delayed specimen.

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Who this module is for

Clinical laboratory scientists and students performing or verifying manual body fluid cell counts

Learning objectives

  • Explain CSF urgency, tube identification, order and allocation, and testing priorities
  • Perform count-chamber setup, dilution, calculation, and QC checks for a manual CSF cell count
  • Recognize clot, traumatic collection, delay, low volume, degeneration, and contamination limitations that affect the result

How completion works

Mark every required section done and answer every knowledge check in those sections correctly. The final save completes the module automatically.

Sources

14 sources

  1. 1. Jurado R, Walker HK. Cerebrospinal Fluid. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Butterworths; 1990. https://www.ncbi.nlm.nih.gov/books/NBK398/.

    Source note · laboratory reference

  2. 2. Clinical and Laboratory Standards Institute. H56, Body Fluid Analysis for Cellular Composition, first edition, July 10, 2006 (archived, retained as technically valid). https://clsi.org/shop/standards/h56/.

    Source note · consensus standard

  3. 3. Centers for Medicare & Medicaid Services. 42 CFR 493.1251, Standard: Procedure manual, 2024 Title 42 compilation. https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol5/pdf/CFR-2024-title42-vol5-sec493-1251.pdf.

    Source note · federal guidance

  4. 4. Centers for Medicare & Medicaid Services. 42 CFR 493.1253, Standard: Establishment and verification of performance specifications, 2024 Title 42 compilation. https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol5/pdf/CFR-2024-title42-vol5-sec493-1251.pdf.

    Source note · federal guidance

  5. 5. Mlinaric A, Vogrinc Z, Drensek Z. Effect of sample processing and time delay on cell count and chemistry tests in cerebrospinal fluid collected from drainage systems. Biochem Med (Zagreb). 2018;28(3):030705. doi:10.11613/BM.2018.030705.

    Source note · peer-reviewed literature

  6. 6. Zimmermann M, Ruprecht K, Kainzinger F, Heppner FL, Weimann A. Automated vs. manual cerebrospinal fluid cell counts: a work and cost analysis comparing the Sysmex XE-5000 and the Fuchs-Rosenthal manual counting chamber. Int J Lab Hematol. 2011;33(6):629-637. doi:10.1111/j.1751-553X.2011.01339.x.

    Source note · peer-reviewed literature

  7. 7. Budhram A, Sangam K, Bridel W, et al. Clinical utility of CSF correction factors for traumatic lumbar puncture in adults. Neurol Clin Pract. 2024;14(6):e200350. doi:10.1212/CPJ.0000000000000350.

    Source note · peer-reviewed literature

  8. 8. Greenberg RG, Smith PB, Cotton CM, et al. Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count. Pediatr Infect Dis J. 2008;27(12):1047-1051. doi:10.1097/INF.0b013e31817e519b.

    Source note · peer-reviewed literature

  9. 9. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35319 Diluting Equipment (Phase II). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  10. 10. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35340 Manual Cell Count Controls (Phase II). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  11. 11. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35347 Counting Chamber and Optical Grid Quality (Phase I). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  12. 12. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35357 Body Fluid Analysis Procedure (Phase II). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  13. 13. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35376 Cell Clumps/Debris - Manual Methods (Phase II). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  14. 14. College of American Pathologists. Hematology, Coagulation, and Clinical Microscopy Checklist, HEM.35395 Red Cell Confirmation Techniques (Phase I). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard