Lab Test

Specimen Collection Manual: Cerebrospinal Fluid (CSF) Specimen Collection, Labeling, and Transport

CSF, Cerebral Spinal Fluid, CSF Specimen Collection and Labeling, Cerebrospinal Fluid (CSF) Specimen Collection and Labeling


csf specimen collection kit
CSF Specimen Collection Kit

Cell Count Procedure
  • The protocol for proper CSF collection requires that an aliquot of CSF be placed in sequentially numbered and properly labeled sterile tubes as the fluid is collected. 
  • Specimens are usually collected in four sterile tubes, which are labeled 1, 2, 3, and 4 in the order in which they are withdrawn.

Specimen Collection Criteria

The CSF tubes/containers, included in the CSF kit, have numbers 1-4 etched near the top of the container. The tube labeled 1 is collected first. Each tube holds a maximum of 8.0 mL. NOTE: (Taylor, Trenton & Wayne only) Please walk all specimens to the lab instead of sending through Pneumatic tube system.

Tube # Test Name Volume Required
Tube 1 CSF Protein, Glucose 1.0-2.0 mL
Tube 1 CSF Oligoclonal Banding (includes IgG)* 1.5 mL
Tube 1 CSF Myelin Basic Protein 1.0 mL
Tube 2 Microbiology/Serology Studies** See below
Tube 3 CSF Cell Count 1.0 mL
Tube 3 CSF Flow Cytometry for Lymphoproliferative Disorder 1.0 mL
Tube 4 Cytology Studies 1.0 mL
Tube 4 Hold 1.0 mL

*Blood (one Gold-top SST tube) is also required.

**Microbiology/Serology Requirements
Lab Section: Microbiology
Tube # Test Name Volume Required
Tube 2 CSF Routine Bacterial Culture 1.0 mL
Tube 2 Fungal Culture 2.0 mL
Tube 2 CSF Viral Culture*** 2.0 mL
Tube 2 CSF Mycobacterial Culture 5.0 - 7.0 mL
Tube 2 Bacterial Antigen Detection 0.5 mL
Tube 2 Cryptococcal Antigen 0.5 mL
Lab Section: Special Testing
Tube 2 CSF Arbovirus IgM Panel 2.0 mL
Tube 2 CSF HSV, VZV, and/or Enterovirus PCR 1.0 mL
Tube 2 CSF Syphilis VDRL 0.5 mL

***There is no need to use viral transport media with CSF as it usually contains enough protein for protection of any viruses that might be present.

Rejection Criteria

Expired media is not acceptable. Check the expiration date on all media prior to specimen collection.

Inpatient Specimen Preparation

  • Send all tubes to the Laboratory STAT after collection.
  • For specimens obtained at Royal Oak, send to the following Pneumatic tube destinations:
    • Send CSF Tubes 1, 3 and 4 to the STAT Lab (Pneumatic tube #309, 311, 720, and 721).
    • Send CSF Tube 2 directly to Microbiology (Pneumatic tube #325).


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