Fat Emulsion as a Cause of Cloudy Cerebrospinal Fluid

LIPIDS or, more specifically, neutral fats are not j customarily described as a cause for a turbid appearance of the cerebrospinal fluid obtained at lumbar puncture. An oily cerebrospinal fluid emulsion may be collected at lumbar puncture from patients who have undergone positive contrast studies with iophendylate (Pantopaque) or iodized oil (Lipiodol). However, under other circumstances, fat is found inconstantly in only trace amounts in the cerebrospinal fluid. The following case report describes the unexpected observation of a purulent-appearing cerebrospinal fluid during a lumbar puncture for myelography. Despite the absence of any clinical evidence of infection, the color of the initial specimen of cerebrospinal fluid suggested a meningeal inflammation. Microscopic analysis of the cloudy specimen of cerebrospinal fluid was necessary to establish the nature of the color abnormality, namely, a finely dispersed, relatively stable fat emulsion. From a study of the sequence of events during the lumbar puncture and subsequent