Neonatal, Adult CSF White Blood Cell Counts Are Similar

Pleocytosis in neonates does not necessarily mean central nervous system infection

FRIDAY, Sept. 15 (HealthDay News) -- The cerebrospinal fluid of normal infants can contain up to five white blood cells (WBCs) per mm3, similar to the profile of a healthy adult, according to a study published in the September issue of the Archives of Disease in Childhood-Fetal and Neonatal Edition.

Ana Martin-Ancel, M.D., of Sant Joan de Deu University Hospital, Barcelona, Spain, and colleagues conducted a study of 30 neonates selected on the basis of two criteria -- those at risk of congenital Toxoplasma infection who had undergone a lumbar puncture in order to assess involvement of the central nervous system (CNS), and those in whom serial specific serum IgG and IgM determinations had ruled out congenital infection. Of the sample, 11 had symptoms and 19 were asymptomatic.

The authors noted that symptomatic infants can display mild pleocytosis without CNS infection, and at the same time patients with meningitis can have apparently normal CSF findings, typically when lumbar punctures are performed at an early stage of infection.

"The results of our study further underline that medicine is more an art, than just mathematics. The CSF cell count should be evaluated in conjunction with other clinical and laboratory findings, in some cases including ancillary tools such as β2 microglobulin. Mild pleocytosis does not necessarily indicate CNS infection," the authors concluded.

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