Document Detail

Cerebrospinal fluid white blood cell counts in infants with myelomeningoceles.
MedLine Citation:
PMID:  24329161     Owner:  NLM     Status:  MEDLINE    
OBJECT: The authors undertook this study to determine white blood cell (WBC) counts in CSF obtained from lateral ventricles and myelomeningoceles (MMCs) in infants in a developing country at the time of their initial presentation for medical evaluation.
METHODS: CSF was aspirated from the lateral ventricles and from MMC sacs of 100 consecutive infants at Kijabe Hospital, Kijabe, Kenya. Peripheral blood WBC counts and CSF WBC counts were determined in the laboratory. CSF with WBC counts of 5 cells/mm(3) or greater was cultured.
RESULTS: The mean WBC count in ventricular CSF was 16 cells/mm(3), with a median and mode of 0 cells/mm(3). The mean WBC count of CSF in MMC sacs was 141 cells/mm(3) (median 15 cells/mm(3)). No child had both a positive culture from ventricular CSF and a negative culture from MMC CSF. There was no correlation between age at presentation and WBC counts in the MMCs. Infants younger than 8 days old were as likely to have high WBC counts in CSF from their MMC sacs as were older children; 7 of 12 infants with 500 WBCs or more in CSF from their MMCs were younger than 8 days old. Only 5 of 58 CSF specimens from MMC sacs with 5 or more WBCs/mm(3) had positive bacterial cultures, which may be a reflection of CSF specimen processing rather than of true culture negativity.
CONCLUSIONS: CSF from ventricular fluid of infants presenting with MMCs infrequently has high WBC counts, so infrequently that it does not need to be evaluated routinely. CSF in MMC sacs often has high WBC counts that suggest the presence of bacterial infection. In developing countries where culture reliability is questionable, intravenous administration of antibiotics before MMC closure for infants with high MMC WBC counts may diminish postoperative meningitis/ventriculitis.
A Leland Albright; Susan S Ferson; Humphrey Okechi
Publication Detail:
Type:  Journal Article     Date:  2013-12-13
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  13     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-02-03     Completed Date:  2014-03-28     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  189-91     Citation Subset:  IM    
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MeSH Terms
Cerebrospinal Fluid / cytology*
Infant, Newborn
Lateral Ventricles
Leukocyte Count*
Medical Records
Meningomyelocele / pathology*
Reproducibility of Results
Retrospective Studies
Comment In:
J Neurosurg Pediatr. 2014 Aug;14(2):219-20   [PMID:  24856880 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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