Neonatal Staphylococcus epidermidis meningitis with unremarkable CSF examination results.
We identified 10 infants (mean +/- SD birth weight, 1000 +/- 500 g; gestation, 29 +/- 3 weeks; postnatal age, 24 +/- 19 days) who had Staphylococcus epidermidis meningitis despite unremarkable cerebrospinal fluid (CSF) blood cell counts and glucose and protein levels. Staphylococcus epidermidis meningitis was diagnosed if all the following criteria were satisfied: (1) a CSF culture positive for S epidermidis within 48 hours, (2) a blood culture positive for S epidermidis with antibiotic sensitivities identical to those of the CSF isolate, and (3) clinical symptomatology. Lumbar puncture yielded white blood cell counts lower than 10 x 10(6)/L in 8 infants. Two subjects had CSF white blood cell counts of 11 x 10(6)/L and 14 x 10(6)/L. Cerebrospinal fluid glucose (2.8 +/- 0.9 mmol/L) and protein (1.15 +/- 0.32 g/L) concentrations were also unremarkable. Infants were treated with parenteral antibiotics for 19 +/- 5 days. There was no mortality or short-term morbidity. Staphylococcus epidermidis is a recognized cause of nosocomial meningitis in low-birth-weight infants and frequently occurs without CSF abnormalities.
Gruskay
J
J
Division of Neonatology, Children's Hospital of Philadelphia, PA 19104.
Harris
M C
MC
Costarino
A T
AT
Polin
R A
RA
Baumgart
S
S
D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000209:etiology; D013129:Spinal Puncture; D013203:Staphylococcal Infections / Q000134:cerebrospinal fluid*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification
D002556:Cerebrospinal Fluid Proteins; D005947:Glucose