Nearly 20% of young febrile infants with UTI have sterile CSF pleocytosis; the clinical course in these infants is similar to that of infants without pleocytosis.
Urinary tract infections (UTIs) are a common cause of serious bacterial infections in young infants. Meningitis is also a concern in infants with febrile UTI because organisms that most often cause the UTI (most notably Escherichia coli) are also associated with neonatal meningitis. In a retrospective review, researchers examined the prevalence of sterile cerebrospinal fluid (CSF) pleocytosis in 1190 febrile infants (age range, 29–60 days) with UTI who underwent nontraumatic lumbar puncture (LP) at 20 North American emergency departments in 1995–2006. Pleocytosis was defined as CSF white blood cell (WBC) count ≥10/μL.
Overall, 214 infants (18%) had CSF sterile pleocytosis; 8% had WBC counts ≥16 /μL and 6% had WBC counts ≥21/μL. Infants with …