J Korean Soc Neonatol.  2012 Aug;19(3):121-126. 10.5385/jksn.2012.19.3.121.

Clinical Predictors of Cerebrospinal Fluid Pleocytosis in Neonates: Clinical Predictors of CSF Pleocytosis in Neonates

• Gwak JH
• Suh WS
• Lee J
• Lee JH
• Sung IK

• KMID: 2188350
• DOI: http://doi.org/10.5385/jksn.2012.19.3.121

Abstract

PURPOSE
Young infants with suspected sepsis routinely undergo laboratory evaluation. In particular, when an infant is a newborn baby, evaluation of the cerebrospinal fluid (CSF) has been frequently included, because the prognosis is poor, irrespectively of the etiology of meningitis. We aimed to examine the clinical predictors of CSF pleocytosis among the newborns.
METHODS
We retrospectively reviewed the records of all infants, aged 30 days or younger, requiring lumbar puncture. Electronic data sources provided the demographic data of the newborns, the clinical manifestations, and all laboratory values. After a univariate analysis, logistic regression analysis was performed to predict newborns at increased risk for CSF pleocytosis.
RESULTS
One hundred thirteen newborns were studied; 20 of whom (17.7%) had CSF pleocytosis. Fever was significantly associated with CSF pleocytosis (P=0.008, OR=5.08, 95% CI, 1.39-18.54). The infants with lethargic appearance also had an increased risk for CSF pleocytosis. Blood urea nitrogen level was higher in patients with pleocytosis. Logistic regression analysis revealed that other clinical features and laboratory data were not significant, except for fever and lethargy. A total of 45% of the infants with CSF pleocytosis were diagnosed with serious bacterial infection, as opposed to 19.4% of those without CSF pleocytosis.
CONCLUSION
In case of neonates, it would be better to perform lumbar puncture, when the infant has fever or lethargic appearance, although, the results of routine laboratory tests were nonspecific.

Keyword

Cerebrospinal fluid; Spinal puncture; Newborn; Meningitis

MeSH Terms

Aged
Bacterial Infections
Blood Urea Nitrogen
Information Storage and Retrieval
Electronics
Electrons
Fever
Humans
Infant
Infant, Newborn
Lethargy
Leukocytosis
Logistic Models
Meningitis
Prognosis
Retrospective Studies
Sepsis
Spinal Puncture