title: Normative cerebrospinal fluid profiles in febrile infants.
abstract: OBJECTIVE
  To describe the cerebrospinal fluid (CSF) profiles of febrile infants aged 1 to 90 days with negative bacterial culture test results and negative results for enteroviruses with polymerase chain reaction.
  
  
  METHODS
  Statistical analysis of a retrospective cohort.
  
  
  RESULTS
  CSF profiles from 823 infants with negative test results for infection were analyzed. For 677 infants with atraumatic lumbar punctures (red blood cell [RBC] count < 1000/mm(3)), the mean and median CSF white blood cell (WBC) counts were 4.3/mm(3) and 3.0/mm(3), respectively, with a range from 0 to 12/mm(3). Mean CSF WBC counts (6.1/mm(3) versus 3.1/mm(3) and 3.0/mm(3)) and protein levels (75.4 mg/dL versus 58.9 mg/dL and 39.2 mg/dL) were higher in the first month compared with months 2 and 3, respectively (P < .001 for all). CSF glucose levels were lower in the first month compared with month 3 (45.3 mg/dL versus 48.0 mg/dL and 57.7 mg/dL; P < .001). Increasing RBC counts were statistically associated with increasing WBC counts (P < .001). However, the contribution of RBC < 10,000/mm(3) was small, and the reference range for WBC in uninfected infants with traumatic lumbar punctures was 0 to 16/mm(3).
  
  
  CONCLUSIONS
  CSF WBC counts in febrile infants without evidence of bacterial or enteroviral infection, even in those with traumatic lumbar puncture, are lower than reported in pediatric references.
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA. Carrie.byington@hsc.utah.edu
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Byington
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kendrick
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sheng
mesh_terms: D004912:Erythrocytes; D005334:Fever / Q000134:cerebrospinal fluid*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007962:Leukocytes; D012189:Retrospective Studies
references.citation: Am J Dis Child. 1982 Apr;136(4):297-8
references.pmid: 7072664
references.citation: J Infect Dis. 2009 Jun 15;199(12):1753-60
references.pmid: 19456229
references.citation: Pediatr Infect Dis J. 2001 Oct;20(10):927-30
references.pmid: 11642625
references.citation: Arch Dis Child. 1981 May;56(5):400-1
references.pmid: 7259264
references.citation: Arq Neuropsiquiatr. 1998 Sep;56(3A):375-80
references.pmid: 9754417
references.citation: Pediatrics. 2003 Mar;111(3):525-8
references.pmid: 12612231
references.citation: Ann Emerg Med. 2000 Dec;36(6):602-14
references.pmid: 11097701
references.citation: J Pediatr. 1976 Mar;88(3):473-7
references.pmid: 1245961
references.citation: N Engl J Med. 1994 Aug 18;331(7):432-8
references.pmid: 8035839
references.citation: Acta Paediatr Suppl. 1958 May;47(Suppl 115):1-102
references.pmid: 13544923
references.citation: Clin Pediatr (Phila). 1986 Oct;25(10):523-6
references.pmid: 3757399
references.citation: Arq Neuropsiquiatr. 1977 Sep;35(3):183-8
references.pmid: 901257
references.citation: J Pediatr. 2008 Aug;153(2):290-2
references.pmid: 18639733
references.citation: Pediatr Infect Dis J. 2003 Dec;22(12):1039-42
references.pmid: 14688561
references.citation: Maandschr Kindergeneeskd. 1954 Aug;22(8):253-63
references.pmid: 13202570
references.citation: Pediatrics. 2006 Mar;117(3):876-81
references.pmid: 16510670
references.citation: Arch Dis Child. 1928 Apr;3(14):96-108
references.pmid: 21031722
references.citation: Pediatrics. 1985 Mar;75(3):484-7
references.pmid: 3975117
references.citation: Hawaii Med J. 1984 Jun;43(6):194, 196, 198
references.pmid: 6381399
references.citation: Pediatrics. 2010 Feb;125(2):257-64
references.pmid: 20064869
references.citation: Pediatr Infect Dis J. 2008 Mar;27(3):241-5
references.pmid: 18277927
references.citation: J Pediatr. 1985 Aug;107(2):249-51
references.pmid: 4020548
references.citation: Pediatr Infect Dis J. 1992 Apr;11(4):257-64
references.pmid: 1533030
references.citation: Pediatrics. 2004 Jun;113(6):1662-6
references.pmid: 15173488
references.citation: J Paediatr Child Health. 2009 Jun;45(6):364-7
references.pmid: 19490407
references.citation: Dev Med Child Neurol. 1983 Apr;25(2):152-61
references.pmid: 6189754
references.citation: Pediatr Infect Dis J. 1992 Jul;11(7):589-91
references.pmid: 1296604
references.citation: Am J Med. 1987 Jun;82(6):1175-81
references.pmid: 3605134
references.citation: Pediatr Infect Dis J. 2006 Jan;25(1):8-11
references.pmid: 16395095
references.citation: Pediatr Infect Dis J. 1996 Apr;15(4):298-303
references.pmid: 8866797
references.citation: Am J Clin Pathol. 1984 Jul;82(1):95-7
references.pmid: 6741880
references.citation: S Afr Med J. 1968 Sep 14;42(35):933-5
references.pmid: 5687812
references.citation: Pediatr Infect Dis J. 2004 May;23(5):480; author reply 480-1
references.pmid: 15131482
references.citation: J Infect Dis. 1990 Jul;162(1):251-4
references.pmid: 2355199
references.citation: Pediatr Infect Dis J. 2001 Jun;20(6):630-2
references.pmid: 11419510