Meningitis in preterm neonates: importance of cerebrospinal fluid parameters.

American Journal of Perinatology
P Brian SmithDaniel K Benjamin

Abstract

Cerebrospinal fluid parameters are of great importance in diagnosing meningitis, but normal values for preterm neonates are based on small, single-center studies. We sought to determine current values for preterm neonate cerebrospinal fluid parameters and assess the association of cerebrospinal fluid parameters with culture proven meningitis. We performed a cohort study of the first lumbar puncture from 4632 neonates < 34 weeks' gestation performed in the years 1997 to 2004 at 150 neonatal intensive care units managed by the Pediatrix Medical Group. We identified 95 cases of meningitis from the 4632 lumbar punctures. The area under the receiver operating characteristic curves for white blood cell count, glucose, and protein were 0.80, 0.63, and 0.72, respectively, for prediction of culture-proven meningitis. Cerebrospinal fluid parameters used to diagnose meningitis in the absence of dependable cerebrospinal fluid cultures are unreliable. Caution should be employed when interpreting cerebrospinal fluid parameters in the premature neonate.

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Citations

Dec 7, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James L WynnUNKNOWN NICHD Neonatal Research Network
Dec 18, 2010·Journal of Perinatology : Official Journal of the California Perinatal Association·R G GreenbergP B Smith
Oct 12, 2012·Indian Journal of Pediatrics·N B MathurT K Mishra
Jul 9, 2013·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·H Ben HamoudaM T Sfar
Nov 28, 2012·Seminars in Perinatology·Lakshmi SrinivasanSamir S Shah
Sep 20, 2011·Early Human Development·James L WynnP Brian Smith
Jun 24, 2010·Clinics in Perinatology·Rose M Viscardi
May 12, 2012·The Journal of Pediatrics·Lakshmi SrinivasanMary C Harris
Feb 14, 2015·Clinics in Perinatology·Lawrence C KuMichael Cohen-Wolkowiez
Aug 4, 2016·Pediatric Research·Lakshmi SrinivasanMary C Harris
Jan 19, 2011·Arquivos de neuro-psiquiatria·Maria Regina BentlinAntonio Rugolo Júnior
Jan 8, 2014·Clinical Microbiology Reviews·Kari A SimonsenH Dele Davies
Jan 13, 2015·Expert Review of Anti-infective Therapy·Kirsten Glaser, Christian P Speer
Feb 3, 2018·PloS One·Lakshmi SrinivasanMary C Harris
Jul 4, 2017·Frontiers in Pediatrics·Scott M GordonMary Catherine Harris
Jul 2, 2019·NeoReviews·Samia Aleem, Rachel G Greenberg
Aug 2, 2020·NeoReviews·Augusto SolaUNKNOWN members of the 10th SIBEN Clinical Consensus
May 2, 2012·Pediatrics·Richard A Polin, UNKNOWN Committee on Fetus and Newborn
Jul 22, 2020·American Journal of Perinatology·Richie DalaiMuralidharan Jayashree

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