Cerebrospinal Fluid Characteristics of Infants Who Present to the Emergency Department With Fever

Chadwick, Sara L.; Wilson, Jesse W.; Levin, Jeffrey S.; Martin, Judith M.

doi:10.1097/inf.0b013e31820ad2ba

Cited by 26 publications

(18 citation statements)

References 12 publications

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“…It is known that the values observed for CSF cell numbers, glucose, and protein in individuals less than 60 days old tend to be different from those observed in older children and adults 16 .…”

Section: Discussionmentioning

confidence: 82%

“…Importantly, children under 6 years of age were the ones that showed the most changes in some parameters when compared to other age groups in these studies 6,16 , which may increase the difficulty in diagnosing this group. The establishment of an early etiological diagnosis, especially in infants, is essential for targeting interventions that save lives 17 .…”

Section: Discussionmentioning

confidence: 84%

“…Because of this, it is so important to have precision in etiologic diagnosis, especially when it comes to individuals in special age groups. In these cases, especially in newborns, viral meningitis may be high-risk diseases, as far as bacterial meningitis 16 .…”

Section: Discussionmentioning

confidence: 99%

“…The analysis of some of the CSF laboratory parameters (PCR, leukocytes, erythrocytes, glucose, and proteins) is often the first clue to the diagnosis 16,18 .…”

Section: Discussionmentioning

confidence: 99%

“…The generation of a set of reference values for CSF parameters, especially in children, is an important area of discussion among health professionals 16 .…”

Section: Introductionmentioning

confidence: 99%

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Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Alves

Wajnsztejn

Alves

et al. 2015

J. Hum. Growth Dev.

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Abstract:Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze the laboratory parameters of CSF in patients with enterovirus meningitis, and then, theirrelationship by age group. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro-Wilk and Kruskal-Wallis tests (CI = 95%, p < 0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/ dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3 , with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged < 2 and < 6 years, and aged < 6 and < 10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion:The parameters of the CSF in patients with enteroviral meningitis showed similar median concentrations to those found in the literature. Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

“…The analysis of some of the CSF laboratory parameters (PCR, leukocytes, erythrocytes, glucose, and proteins) is often the first clue to the diagnosis 16,18 .…”

Section: Discussionmentioning

confidence: 99%

“…The generation of a set of reference values for CSF parameters, especially in children, is an important area of discussion among health professionals 16 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Alves

Wajnsztejn

Alves

et al. 2015

J. Hum. Growth Dev.

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Adjustment of cerebrospinal fluid protein for red blood cells in neonates and young infants

Hines

Nigrovic

Neuman

et al. 2012

Journal of Hospital Medicine

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OBJECTIVE:To determine the relationship between cerebrospinal fluid (CSF) red blood cell (RBC) count and CSF protein in neonates and young infants undergoing lumbar puncture.DESIGN:Cross‐sectional study.SETTING:Urban tertiary care children's hospital.PATIENTS:Infants 56 days of age and younger who had a lumbar puncture in the emergency department between January 1, 2005 and July 31, 2009 were eligible for inclusion. Infants with missing laboratory data, exceedingly high CSF red blood cell counts, or conditions known to elevate CSF protein were excluded.MEASUREMENTS:Linear regression was used to determine the association between CSF RBC and CSF protein.RESULTS:Of 1986 infants, 56 days of age or younger, who underwent lumbar puncture in the emergency department during the study period, 1241 (62.5%) met inclusion criteria. The median age was 34 days (interquartile range: 19‐46 days); 45% of patients were male. The median CSF RBC count was 40 cells/mm3 (interquartile range: 2‐1080 cells/mm3); 11.8% of patients had a CSF RBC >10,000 cells/mm3. CSF protein increased by 1.9 mg/dL (95% confidence interval: 1.7‐2.1 mg/dL) per 1000 CSF RBCs for all included patients. Restricting analysis to patients without pleocytosis yielded comparable results, as did subanalyses by age and delivery type.CONCLUSIONS:We found that CSF protein concentrations increased by approximately 2 mg/dL for every 1000 CSF RBCs. These data may assist clinicians in interpreting CSF protein concentrations in infants 56 days of age and younger in the context of traumatic lumbar punctures. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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Developmental Anatomy and Physiology of the Central Nervous System in Children

Rajagopalan

Mariappan

2021

Fundamentals of Pediatric Neuroanesthesia

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Cerebrospinal Fluid Characteristics of Infants Who Present to the Emergency Department With Fever

Abstract: Significant differences exist for infants by week of age for CSF WBC and CSF protein. These values can be used to assist in interpreting laboratory findings and making management decisions for infants less than 60 days of age.

Cited by 26 publications

References 12 publications

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Adjustment of cerebrospinal fluid protein for red blood cells in neonates and young infants

Developmental Anatomy and Physiology of the Central Nervous System in Children

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