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Cited by 81Bacterial Infections and VaccinesClinical Laboratory Practices and Quality ControlCerebrospinal fluid and hydrocephalus

Cerebrospinal fluid reference values for young infants undergoing lumbar puncture.

Thomson, Joanna, Sucharew, Heidi, Cruz, Andrea T., Nigrovic, Lise E., Freedman, Stephen B., Garro, Aris C., Balamuth, Fran, Mistry, Rakesh D. +6 more·2018·Pediatrics
DOI 10.1542/peds.2017-3405
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Abstract

OBJECTIVES: To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age. METHODS: This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of >72 hours were excluded. Reference standards were determined for infants ≤28 days of age and 29 to 60 days of age by using the third quartile +1.5 interquartile range for WBC and protein and the first quartile −1.5 interquartile range for glucose. CSF parameter centile curves based on age were calculated by using the LMST method. RESULTS: A total of 7766 patients were included. CSF WBC counts were higher in infants ≤28 days of age (upper bound: 15 cells/mm3) than in infants 29 to 60 days of age (upper bound: 9 cells/mm3; P < .001). CSF protein concentrations were higher in infants ≤28 days of age (upper bound: 127 mg/dL) than in infants 29 to 60 days of age (upper bound: 99 mg/dL; P < .001). CSF glucose concentrations were lower in infants ≤28 days of age (lower bound: 25 mg/dL) than in infants 29 to 60 days of age (lower bound: 27 mg/dL; P < .001). CONCLUSIONS: The age-specific CSF WBC count, protein concentration, and glucose concentration reference values identified in this large, multicenter cohort of infants can be used to interpret the results of lumbar puncture in infants ≤60 days of age.

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  • When possible, a full 10-day course of penicillin is preferred, even if ampicillin was initially provided for possible sepsis.

    “When possible, a full 10-day course of penicillin is preferred, even if ampicillin was initially provided for possible sepsis (648–650).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [650]

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Authors
Thomson, J., Sucharew, H., Cruz, A. T., Nigrovic, L. E., Freedman, S. B., Garro, A. C., Balamuth, F., Mistry, R. D., Arms, J. L., Ishimine, P. T., Kulik, D. M., Neuman, M. I., Shah, S. S., & for the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC) HSV Study Group
Affiliations
  • Divisions of Hospital Medicine,
  • Biostatistics and Epidemiology, and
  • Baylor College of Medicine (US)
  • Boston Children's Hospital (US)
  • University of Calgary (CA)
  • Brown University (US)
  • University of Pennsylvania (US)
  • University of Colorado Anschutz (US)
  • Children's Minnesota (US)
  • University of California San Diego (US)
  • University of Toronto (CA)
  • Cincinnati Children's Hospital Medical Center (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2018-03-01
Volume
141
Issue
3
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2017-3405
OpenAlex
W2789687729
Cited by
81
References
45
Citations by year
2026: 8 · 2025: 1 · 2024: 16 · 2023: 10 · 2022: 8 · 2021: 14 · 2020: 10 · 2019: 10 · 2018: 4
FWCI
7.66
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
Keywords
cerebrospinal fluid, reference values, infants, lumbar puncture, white blood cell count, cerebrospinal fluid protein, CSF glucose, age-related changes, centile curves, cerebrospinal fluid culture
MeSH terms
Age Factors, Cerebrospinal Fluid Proteins, Cross-Sectional Studies, Glucose, Humans, Infant, Infant, Newborn, Leukocyte Count, Reference Values, Retrospective Studies, Spinal Puncture

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