BACKGROUND: @entity5827 is often reported to be characterized by a mononuclear cell predominance in the cerebrospinal fluid (CSF), whereas @entity4008 is characterized by a polymorphonuclear (PMN) cell predominance. In contrast, other studies suggest that PMNs can be the most prevalent cell in early @entity5827 followed by a shift to mononuclear cells within 24 hours. These contradictory reports may lead to uncertainty in the diagnosis and treatment of @entity693 . OBJECTIVES: To assess 1) the characteristics of the CSF differential in aseptic versus @entity4008 , 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus @entity4008 . METHODS: A retrospective chart review was conducted of all cases of @entity693 in @entity1 >30 days of age hospitalized during the peak months for @entity693 (April to October) between 1992 to 1997. Cases of @entity5827 were defined as having at least 20 white blood cells/mm(3) and the absence of bacterial growth on culture. @entity1 were excluded if they received antibiotic therapy within the previous 5 days. Cases of @entity4008 were defined as having a positive culture of the CSF or the presence of a CSF pleocytosis with positive cultures of the blood. CSF variables including white blood cell differential and time from the onset of symptoms to the performance of a lumbar puncture were analyzed. PMNs were considered to be predominant when the percentage of neutrophils added to juvenile forms was >50% of cells. RESULTS: One hundred fifty-eight cases of @entity693 were reviewed: 138 were aseptic and 20 were bacterial. The @entity1 ranged in age from 30 days to 18 years; 61% were male. Fifty-seven percent of cases of @entity5827 had a PMN predominance. The percentage of PMNs in the CSF in @entity1 with @entity5827 was not statistically different for @entity1 who had a lumbar puncture performed either within or beyond 24 hours of the onset of symptoms. Fifty-one percent of the 53 @entity1 with @entity5827 and duration of illness >24 hours had a PMN predominance. The ability of a PMN predominance to differentiate between aseptic and @entity4008 was assessed. The sensitivity of a PMN predominance for @entity5827 is 57% whereas the specificity is 10%. The positive predictive value of a PMN predominance for @entity66 is 81% but the negative predictive value is 3%. Alternative definitions of PMN predominance from 60% to 90% were not useful as a clinical indicator of @entity4577 . CONCLUSIONS: The majority of @entity1 with @entity5827 have a PMN predominance in the CSF. The PMN predominance is not limited to the first 24 hours of illness. Because the majority of @entity1 with a PMN predominance during enteroviral season will have @entity66 , a PMN predominance as a sole criterion does not discriminate between aseptic and @entity4008 .

Cerebrospinal fluid findings in aseptic versus XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['aseptic disease'] @entity4008 :: ('MESH:D016920', 'Disease') :: ['bacterial meningitis'] @entity5827 :: ('MESH:D008582', 'Disease') :: ['aseptic meningitis', 'Aseptic meningitis'] @entity693 :: ('MESH:D008581', 'Disease') :: ['enteroviral meningitis', 'meningitis'] @entity4577 :: ('MESH:D017192', 'Disease') :: ['bacterial disease']
@entity4008 :: (MESH:D016920,Disease) :: ['bacterial meningitis']
