2/26/2024 0 Comments Meningitis csf findingsAlso, additional studies have been published in recent years. However, many studies included children in whom antibiotics were given before LP or in whom viral meningitis was not excluded reliably. Age-related normal values of CSF findings have previously been reviewed. The blood-brain barrier in neonates differs to that in older children, and normal values in infants, particularly neonates, are therefore different from those in older children. Furthermore, there is ongoing uncertainty about age-related normal values of CSF parameters, especially in neonates. Even with all these parameters available, it is often difficult to diagnose meningitis and to differentiate bacterial from aseptic meningitis. This is also the case when antibiotics are administered before lumbar puncture (LP). However, the diagnosis often depends on the microscopic and biochemical findings in the CSF, including a Gram stain, white blood cell (WBC) count, and differential, together with protein and glucose concentrations. The gold standard for diagnosing bacterial meningitis is the isolation of pathogens in the cerebrospinal fluid (CSF). CSF parameters alone are not sufficiently reliable to exclude meningitis. Conclusion: The normal range for CSF parameters in neonates is different to that in older infants, and some parameters are influenced by gestational and chronological age. In the four studies that reported individual patient data, in 95% of cases the CSF WBC count was <12 cells/μL in preterm and <10 cells/μL in term neonates, the neutrophil count was <16 and 8 cells/μL, and the protein concentration was <210 and 110 mg/dL, respectively. In contrast, the CSF neutrophil count and protein concentration were influenced by gestational and chronological age. There were minimal differences between preterm and term neonates in the CSF white blood cell (WBC) count and glucose concentration. Results: We identified seven studies investigating 270 term and 96 preterm neonates. Methods: A systematic search was done using MEDLINE and EMBASE to identify original studies which investigated CSF normal values in either healthy neonates or febrile neonates in whom bacterial and viral meningitis were reliably excluded. There is ongoing uncertainty about age-related normal values for CSF findings in neonates, and many previous studies have included infants in whom antibiotics were administered before lumbar puncture or in whom viral meningitis was not excluded. Background: The diagnosis of neonatal meningitis often rests on microscopic and biochemical findings in the cerebrospinal fluid (CSF).
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