PMID: 3320931Nov 1, 1987Paper

Bacterial meningitis presenting with normal cerebrospinal fluid

The Pediatric Infectious Disease Journal
D B Polk, R W Steele

Abstract

At a large children's hospital cases of bacterial meningitis with normal initial cerebrospinal fluid determinations other than culture or antigen detection assays were reviewed in an attempt to determine clinical or other laboratory findings accompanying this presentation. During a 5-year period from January, 1980, through December, 1985, 7 of 261 pediatric meningitis patients (2.7%) fulfilled these criteria. Ages ranged from 3 weeks to 18 months. All 7 patients were hospitalized for observation with all but 1 begun on empiric antibiotic therapy. Laboratory parameters such as a complete blood count, sedimentation rate or C-reactive protein did not influence decisions for management. Cerebrospinal fluid antigen detection assays were negative in all but one patient with pneumococcal meningitis. Review of these cases did not reveal unique indicators for bacterial meningitis. The results emphasize that the physician must rely on clinical judgment in initiating empiric antimicrobial therapy once apparently normal cerebrospinal fluid parameters are observed.

Citations

Apr 14, 2010·PloS One·Sarah JesseMarkus Otto
Oct 8, 2013·Diagnostic Microbiology and Infectious Disease·Priscilla H WongDawn F Muench
Apr 2, 1999·The American Journal of Emergency Medicine·A Gutiérrez-MacíasM Martinez-Ortiz de Zarate
Sep 1, 1991·The Journal of Pediatrics·L E RodewaldK R Powell
Nov 1, 1994·The Journal of Infection·M T CollJ Lite
Aug 12, 2009·The Journal of Emergency Medicine·Ashley M Maranich, Martin Weisse
Nov 1, 2015·The American Journal of Emergency Medicine·Ryota SatoYusuke Kitahara
Aug 28, 2016·The American Journal of Emergency Medicine·Michelle Troendle, Deanna Willis
Sep 11, 2012·BMC Pediatrics·Christine KellyUNKNOWN Northwest Neurological Infections Network
Aug 30, 2017·Archives of Disease in Childhood·Marita Macken, Ian D Wacogne

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