The 23-year-old patient is brought to the emergency department after contacting emergency services to report profound weakness that started in his feet and worsened and spread cranially over the past few days. He reports severe diarrhea after a camping trip a week ago. Upon assessment, strength, sensation, and deep tendon reflexes are significantly reduced, with the lower extremities more severely affected than his upper extremities. Vital signs are normal and the patient seems to be breathing well. The nurse anticipates which finding on the lumbar puncture result?

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Increased protein. The patient is exhibiting signs of Guillain-Barre syndrome (weakness that starts in the lower extremities and spreads upwards after a diarrheal illness), which presents with increased protein in the cerebrospinal fluid. Increased leukocytes indicate meningitis (nuchal rigidity). Erythrocytes in the CSF indicate trauma to a spinal blood vessel during the lumbar puncture (LP). Decreased glucose level in CSF generally indicates a bacterial meningitis because the glucose is a food source to the bacteria.

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