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Cited by 80Bacterial Infections and VaccinesNeonatal and Maternal InfectionsPediatric Urology and Nephrology Studies

Normative Cerebrospinal Fluid Profiles in Febrile Infants

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Byington, Carrie L., Kendrick, Jeremy, Sheng, Xiaoming·2011·The Journal of Pediatrics
DOI 10.1016/j.jpeds.2010.07.022PMC PMC2994954
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Abstract

Objective To describe the cerebrospinal fluid (CSF) profiles of febrile infants aged 1 to 90 days with negative bacterial culture test results and negative results for enteroviruses with polymerase chain reaction.Study design Statistical analysis of a retrospective cohort.Results CSF profiles from 823 infants with negative test results for infection were analyzed. For 677 infants with atraumatic lumbar punctures (red blood cell [RBC] count < 1000/mm(3)), the mean and median CSF white blood cell (WBC) counts were 4.3/mm(3) and 3.0/mm(3), respectively, with a range from 0 to 12/mm(3). Mean CSF WBC counts (6.1/mm(3) versus 3.1/mm(3) and 3.0/mm(3)) and protein levels (75.4 mg/dL versus 58.9 mg/dL and 39.2 mg/dL) were higher in the first month compared with months 2 and 3, respectively (P < .001 for all). CSF glucose levels were lower in the first month compared with month 3 (45.3 mg/dL versus 48.0 mg/dL and 57.7 mg/dL; P < .001). Increasing RBC counts were statistically associated with increasing WBC counts (P < .001). However, the contribution of RBC < 10,000/mm(3) was small, and the reference range for WBC in uninfected infants with traumatic lumbar punctures was 0 to 16/mm(3).Conclusion CSF WBC counts in febrile infants without evidence of bacterial or enteroviral infection, even in those with traumatic lumbar puncture, are lower than reported in pediatric references.

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  • 14 infants (39%) with viral pathogens had CSF pleocytosis, defined as a CSF WBC count of >14.

    “Of these, 14 infants (39%) had CSF pleocytosis, defined as a CSF white blood cell (WBC) count of >14”

    From Retrospective Evaluation of Infants Aged 1 to 60 Days with Residual Cerebrospinal Fluid (CSF) Tested Using the FilmArray Meningitis/Encephalitis (ME) Panel (2018) · cites this paper as [13]

    The Discussion (page unavailable) identifies CSF WBC counts >14.5/mm³ as outliers in infants with atraumatic lumbar punctures, consistent with >14 for whole-number counts. It does not report that 14 infants (39%) with viral pathogens had pleocytosis; the Methods instead use presumptively uninfected infants to establish normative values. (LLM, conf=0.82)

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Research works printed but not linked: 4

  1. [7]Wyers H Bakker J De liquor cerebro-spinalis van normale, a terme geboren neonati Maandschrift Kindergenceskunde 1954 22 253 63 13202570
  2. [11]Vaz FA Livramento JA Spina-Franca A Cerebrospinal fluid in the healthy preterm newborn infant Arq Neuropsiquiatr 1977 35 3 183 8 901257
  3. [37]Smithson M Confidence intervals Quantitative Applications in the Social Sciences Series Belmont, CA SAGE Publications 2003
  4. [44]Choukair M Blood Chemistries/Body Fluids Siberry G Iannone R The Harriet Lane Handbook 15 St Louis, MI Mosby 2000

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Authors
Byington, C. L., Kendrick, J., & Sheng, X.
Affiliations
University of Utah (US)
Corresponding author
Byington, Carrie L.
ORCID
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
2011-01
Volume
158
Issue
1
Pages
130-134
ISSN
0022-3476 (ISSN-L)
DOI
10.1016/j.jpeds.2010.07.022
PMC
PMC2994954
OpenAlex
W2001148322
Cited by
80
References
46
Citations by year
2026: 4 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 4 · 2017: 5 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 8
FWCI
5.29
Type
journal article
Language
en
Update notices
erratum (2019-05-01)
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5k24hd047249-05)
  • National Center for Research Resources (UL1RR025764, M01RR000064)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24- HD047249)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
Keywords
cerebrospinal fluid, febrile infants, CSF white blood cell count, cerebrospinal fluid protein, CSF glucose, reference values, traumatic lumbar puncture, red blood cell count, bacterial meningitis, enterovirus
MeSH terms
Erythrocytes, Fever, Humans, Infant, Infant, Newborn, Leukocytes, Retrospective Studies

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