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Cerebrospinal Fluid Cell Counts and Chemistries in Bacterial Meningitis
Abstract
We evaluated the records of 428 patients with bacterial meningitis to document initial cerebrospinal fluid (CSF) findings and detail their changes during therapy. Compared to patients with an initial polymorphonuclear cell predominance in the CSF, patients with initial CSF lymphocytosis had lower CSF leukocyte counts, milder CSF chemical abnormalities, and a lower frequency of positive CSF Gram stains and cultures. These findings suggest that CSF lymphocytosis may represent an early phase of infection. A low CSF leukocyte count was associated with a poor outcome, presumably reflecting an inadequate host response to infection. The CSF white cell count increased during the first 24 hours of therapy in 45% of cases. Morbidity and case fatality rates were not significantly increased in this group, suggesting that an initial rise in the CSF leukocyte count does not reflect a poor response to therapy.
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CSF WCC may be normal (especially in early disease or immunodeficiency), and lymphocytes may predominate in partially antibiotic-treated ABM or L. monocytogenes meningitis.
“WCC, however, may be normal (especially in early disease or immunodeficiency), and lymphocytes may predominate in partially antibiotic-treated ABM or L. monocytogenes meningitis.42”
From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [42]
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Management of acute community-acquired bacterial meningitis (excluding newborns). Short text
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“22 CSF Gram stain and culture were more frequently negative than in patients who had polymorphonuclear predominant CSF. CSF lymphocytosis denotes earlier stage of the disease where the small bacterial load in the CSF results in majority of Gram stain and culture becoming negative.”
BackgroundDiagnosis and Treatment of Altered Mental Status
Riggeal, B. D., Waked, C. S., & Okun, M. S. (2013) · Springer eBooks · doi:10.1007/978-1-4471-5226-2_23 · Cited by 1
Emergency Department Stabilization of Pediatric Patients with Bacterial Meningitis
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Mitra, S., Bhuiyan, R. H., Arifuzzaman, M., et al. (2013) · Chittagong University Journal of Biological Sciences · doi:10.3329/cujbs.v6i1-2.17080
“If the CSF is brown, orange or yellow, it may be a sign of increased CSF protein or previous bleeding (Arevalo et al. 1989) and could be associated with pyogenic meningitis and or tuberculous meningitis (Conly et al. 1983).”
BackgroundClinical Biochemistry of the Central Nervous System
Firth, G., Cowdrey, G., & Frost, S. J. (1994) · Elsevier eBooks · doi:10.1016/b978-0-7506-0167-2.50037-6 · Cited by 2
Mosaad, M., Shedid, M., Soliman, N., et al. (2015) · International Journal of TROPICAL DISEASE & Health · doi:10.9734/ijtdh/2015/17884
“In septic meningitis the number of cells were increased and mainly polymorphs but in aseptic meningitis the number of cells didn't not exceed 1000 /ml, and mainly lymphocytes [17].”
BackgroundPfister, H., Roos, K. L., & Bleck, T. P. (1994) · Neurocritical Care · doi:10.1007/978-3-642-87602-8_36
Diagnosis and Treatment of Altered Mental Status
Robinson, C. P. (2024) · Springer eBooks · doi:10.1007/978-3-031-62220-5_5
Metadata
- Authors
- AREVALO, C. E., BARNES, P. F., DUDA, M., & LEEDOM, J. M.
- Affiliations
- University of Southern California (US)
- Venue
- Southern Medical Journal
- Publisher
- Southern Medical Association
- Published
- 1989-09
- Volume
- 82
- Issue
- 9
- Pages
- 1122-1127
- ISSN
- 0038-4348 (ISSN-L)
- OpenAlex
- W22722619
- Cited by
- 26
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2019: 4 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2013: 2
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Southern Medical Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (RR00043)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
- Keywords
- bacterial meningitis, cerebrospinal fluid, CSF cell count, CSF leukocyte count, cerebrospinal fluid culture, host response to infection, treatment response, case fatality, morbidity
- MeSH terms
- Acute Disease, Adolescent, Adult, Anti-Bacterial Agents, Child, Child, Preschool, Female, Glucose, Humans, Infant, Leukocyte Count, Lymphocytosis, Male, Meningitis, Haemophilus, Meningitis, Meningococcal, Meningitis, Pneumococcal, Neutrophils, Prognosis, Retrospective Studies, Severity of Illness Index, Time Factors
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