Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures.
OBJECTIVE
The purpose of this study was to examine the frequency of normal cerebrospinal fluid (CSF) parameters in Candida meningitis and the proportion of candidemia associated with Candida meningitis.


METHODS
We evaluated the initial lumbar puncture results from infants discharged from 150 Neonatal Intensive Care Units between 1997 and 2004. Candida meningitis was diagnosed by a positive CSF culture or positive Gram stain for yeast. We calculated two-tailed P-values using non-parametric testing, Mann-Whitney, Kruskal-Wallis or Fisher's exact tests where appropriate.


RESULTS
Twenty infants had culture-positive Candida meningitis. Normal CSF parameters were found in 43% (3/7) of the infants with Candida meningitis and only 37% (7/19) of them had positive blood cultures for Candida.


CONCLUSIONS
Normal CSF parameters do not exclude the diagnosis of neonatal Candida meningitis. The majority of infants in this cohort with Candida meningitis did not have evidence of candidemia at the time of diagnosis.
Cohen-Wolkowiez
M
M
Department of Pediatrics, Duke University, Durham, NC 27705, USA.
Smith
P B
PB
Mangum
B
B
Steinbach
W J
WJ
Alexander
B D
BD
Cotten
C M
CM
Clark
R H
RH
Walsh
T J
TJ
Benjamin
D K
DK
D001786:Blood Glucose / Q000032:analysis; D002177:Candidiasis / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000382:microbiology; D018805:Sepsis / Q000134:cerebrospinal fluid / Q000382:microbiology*
D001786:Blood Glucose