Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis

John T. Kanegaye, Lise E. Nigrovic, Richard Malley, Christopher R. Cannavino, Sandra H. Schwab, Jonathan E. Bennett, Michael M. Mohseni, Vincent J. Wang, Yiannis L. Katsogridakis, Martin I. Herman, Nathan Kuppermann

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 (≥10 × 106 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 × 106 cells per L vs 3 × 106 cells per L; difference: 389 × 106 cells per L; 95% confidence interval: -77 × 106 cells per L to 855 × 106 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.

Original languageEnglish (US)
JournalPediatrics
Volume123
Issue number6
DOIs
StatePublished - Jun 2009

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Leukocytosis
Cerebrospinal Fluid
Neutrophils
Bacterial Meningitides
Aseptic Meningitis
Confidence Intervals
Multicenter Studies
Hospital Emergency Service
Leukocytes
Multivariate Analysis

Keywords

  • Aseptic meningitis
  • Bacterial meningitis
  • Bands
  • Cerebrospinal fluid
  • Immature neutrophils

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis. / Kanegaye, John T.; Nigrovic, Lise E.; Malley, Richard; Cannavino, Christopher R.; Schwab, Sandra H.; Bennett, Jonathan E.; Mohseni, Michael M.; Wang, Vincent J.; Katsogridakis, Yiannis L.; Herman, Martin I.; Kuppermann, Nathan.

In: Pediatrics, Vol. 123, No. 6, 06.2009.

Research output: Contribution to journalArticle

Kanegaye, JT, Nigrovic, LE, Malley, R, Cannavino, CR, Schwab, SH, Bennett, JE, Mohseni, MM, Wang, VJ, Katsogridakis, YL, Herman, MI & Kuppermann, N 2009, 'Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis', Pediatrics, vol. 123, no. 6. https://doi.org/10.1542/peds.2008-1742
Kanegaye, John T. ; Nigrovic, Lise E. ; Malley, Richard ; Cannavino, Christopher R. ; Schwab, Sandra H. ; Bennett, Jonathan E. ; Mohseni, Michael M. ; Wang, Vincent J. ; Katsogridakis, Yiannis L. ; Herman, Martin I. ; Kuppermann, Nathan. / Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis. In: Pediatrics. 2009 ; Vol. 123, No. 6.
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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 (≥10 × 106 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 × 106 cells per L vs 3 × 106 cells per L; difference: 389 × 106 cells per L; 95{\%} confidence interval: -77 × 106 cells per L to 855 × 106 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.",
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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

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Y1 - 2009/6

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 (≥10 × 106 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 × 106 cells per L vs 3 × 106 cells per L; difference: 389 × 106 cells per L; 95% confidence interval: -77 × 106 cells per L to 855 × 106 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.

AB - 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 (≥10 × 106 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 × 106 cells per L vs 3 × 106 cells per L; difference: 389 × 106 cells per L; 95% confidence interval: -77 × 106 cells per L to 855 × 106 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.

KW - Aseptic meningitis

KW - Bacterial meningitis

KW - Bands

KW - Cerebrospinal fluid

KW - Immature neutrophils

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