A large retrospective study supports current practice.
Many febrile infants undergoing lumbar puncture (LP) have a traumatic LP, resulting in contamination of cerebrospinal fluid (CSF) with blood, with consequent increases in the CSF white blood cell (WBC) count. Traditional teaching is that WBC counts from traumatic LPs can be corrected by subtracting the number of WBC/mm3 attributable to blood, defined as 1 WBC per 1000 red blood cells (RBCs).
To determine the optimal correction factor for infants aged ≤60 days, investigators performed a preplanned secondary analysis of CSF WBC and RBC counts from LPs performed at 20 centers. CSF pleocytosis was defined as ≥20 WBC/mm3 for infants aged ≤28 days and ≥10 WBC/mm3 for those aged 29–60 days.
Of 20,319 LPs, 2880 (14%) were traumatic, and of those, 33 …
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals