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Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis.
Pediatrics. 2009 Jun; 123(6):e967-71.Ped

Abstract

OBJECTIVE

We evaluated the diagnostic utility of the presence and number of cerebrospinal fluid (CSF) bands in distinguishing bacterial from aseptic meningitis among children with CSF pleocytosis.

METHODS

We identified retrospectively a cohort of children 29 days to 19 years of age with CSF pleocytosis (> or =10 x 10(6) leukocytes per L) who were treated in the emergency departments of 8 pediatric centers between January 2001 and June 2004 and whose CSF was evaluated for the presence of bands. We performed bivariate and multivariate analyses to determine the ability of CSF bands to distinguish bacterial from aseptic meningitis.

RESULTS

Among 1116 children whose CSF was evaluated for the presence of bands, 48 children (4% of study patients) had bacterial meningitis. Bacterial meningitis, compared with aseptic meningitis, was associated with a greater CSF band proportion (0.03 vs 0.01; difference: 0.02; 95% confidence interval: 0.00-0.04) and CSF absolute band count (392 x 10(6) cells per L vs 3 x 10(6) cells per L; difference: 389 x 10(6) cells per L; 95% confidence interval: -77 x 10(6) cells per L to 855 x 10(6) cells per L). In addition, 29% of patients with bacterial meningitis, compared with 18% of patients with aseptic meningitis, had any bands detected in the CSF. After adjustment for other factors associated with bacterial meningitis, however, CSF band presence, CSF absolute band count, and CSF band proportion were not independently associated with bacterial meningitis.

CONCLUSION

In this multicenter study, neither the presence nor quantity of CSF bands independently predicted bacterial meningitis among children with CSF pleocytosis.

Authors+Show Affiliations

Division of Emergency Medicine, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5075, San Diego, CA 92123, USA. jkanegaye@rchsd.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19451189

Citation

Kanegaye, John T., et al. "Diagnostic Value of Immature Neutrophils (bands) in the Cerebrospinal Fluid of Children With Cerebrospinal Fluid Pleocytosis." Pediatrics, vol. 123, no. 6, 2009, pp. e967-71.
Kanegaye JT, Nigrovic LE, Malley R, et al. Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis. Pediatrics. 2009;123(6):e967-71.
Kanegaye, J. T., Nigrovic, L. E., Malley, R., Cannavino, C. R., Schwab, S. H., Bennett, J. E., Mohseni, M. M., Wang, V. J., Katsogridakis, Y. L., Herman, M. I., & Kuppermann, N. (2009). Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis. Pediatrics, 123(6), e967-71. https://doi.org/10.1542/peds.2008-1742
Kanegaye JT, et al. Diagnostic Value of Immature Neutrophils (bands) in the Cerebrospinal Fluid of Children With Cerebrospinal Fluid Pleocytosis. Pediatrics. 2009;123(6):e967-71. PubMed PMID: 19451189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis. AU - Kanegaye,John T, AU - Nigrovic,Lise E, AU - Malley,Richard, AU - Cannavino,Christopher R, AU - Schwab,Sandra H, AU - Bennett,Jonathan E, AU - Mohseni,Michael M, AU - Wang,Vincent J, AU - Katsogridakis,Yiannis L, AU - Herman,Martin I, AU - Kuppermann,Nathan, AU - ,, Y1 - 2009/05/18/ PY - 2009/5/20/entrez PY - 2009/5/20/pubmed PY - 2009/6/18/medline SP - e967 EP - 71 JF - Pediatrics JO - Pediatrics VL - 123 IS - 6 N2 - OBJECTIVE: We evaluated the diagnostic utility of the presence and number of cerebrospinal fluid (CSF) bands in distinguishing bacterial from aseptic meningitis among children with CSF pleocytosis. METHODS: We identified retrospectively a cohort of children 29 days to 19 years of age with CSF pleocytosis (> or =10 x 10(6) leukocytes per L) who were treated in the emergency departments of 8 pediatric centers between January 2001 and June 2004 and whose CSF was evaluated for the presence of bands. We performed bivariate and multivariate analyses to determine the ability of CSF bands to distinguish bacterial from aseptic meningitis. RESULTS: Among 1116 children whose CSF was evaluated for the presence of bands, 48 children (4% of study patients) had bacterial meningitis. Bacterial meningitis, compared with aseptic meningitis, was associated with a greater CSF band proportion (0.03 vs 0.01; difference: 0.02; 95% confidence interval: 0.00-0.04) and CSF absolute band count (392 x 10(6) cells per L vs 3 x 10(6) cells per L; difference: 389 x 10(6) cells per L; 95% confidence interval: -77 x 10(6) cells per L to 855 x 10(6) cells per L). In addition, 29% of patients with bacterial meningitis, compared with 18% of patients with aseptic meningitis, had any bands detected in the CSF. After adjustment for other factors associated with bacterial meningitis, however, CSF band presence, CSF absolute band count, and CSF band proportion were not independently associated with bacterial meningitis. CONCLUSION: In this multicenter study, neither the presence nor quantity of CSF bands independently predicted bacterial meningitis among children with CSF pleocytosis. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/19451189/Diagnostic_value_of_immature_neutrophils__bands__in_the_cerebrospinal_fluid_of_children_with_cerebrospinal_fluid_pleocytosis_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=19451189 DB - PRIME DP - Unbound Medicine ER -