Immature WBCs in CSF Do Not Indicate Bacterial Meningitis

Meningitis is defined as a cerebrospinal fluid (CSF) white blood cell (WBC) count ≥10×10⁶/L. Although leukocytosis resulting from any etiology begins with release of immature WBCs (“bands”) from the bone marrow, many physicians believe that band forms indicate bacterial infection. To assess whether presence and number of CSF bands predict bacterial etiology, researchers conducted a retrospective chart review of all cases of meningitis diagnosed at eight U.S. pediatric emergency departments from 2001 through 2004. Children who required hospital admission for other reasons and those who were pretreated with antibiotics were excluded.

Of 1116 eligible children, 4% had bacterial meningitis. In multivariate analysis, neither the absolute CSF band…