Characteristics of cerebrospinal fluid in neonatal purulent meningitis

Abstract

Objective To analyze the changes of WBC classification, sugar and protein in cerebrospinal fluid(CSF) and pathogenic bacteria of neonatal purulent meningitis. Methods Thirty-one neonates with bacterial meningitis in our department of neonatology from June 2011 to June 2013 were enrolled, and the clinical features, pathogenic bacteria, laboratory examination of CSF were analyzed. Results Fever(90.3%), convulsions(67.7%) and changed consciousness(58.1%) were common clinical symptoms.The incidences of other nervous system abnormal signs such as gastrointestinal dysfunction(25.8%), abnormal breathing(16.1%), cervical resistance(16.1%), bulging fontanel(9.7%) were lower.The Gram-negative bacteria was more than Gram-positive in both blood and CSF culture.The escherichia coli was the most common bacteria, with positive rate of 38.1%(8/21)in blood culture and 55.5%(5/9)in CSF culture.The germiculture positive rate in CSF was lower than in blood culture (29.0% vs.67.7%). Polymorphonuclear leukocyte(PMN)[(79.61±12.06)%] was the most predominant cell of the leukocyte classification in CSF within 1 week in all cases, PMN was still predominant in 1 to 2 weeks in 7 cases, while only 2 cases in 2 to 3 weeks still dominated by PMN, PMN was not the predominant cell 3 weeks later. Conclusion In the typical neonatal purulent meningitis, PMN was the predominant cell in CSF within the first week, but the proportion of monocyte gradually increased and was dominant later.Escherichia coli was a common bacteria caused by this disease. Key words: Purulent meningitis; Neonate; bacteria; Cerebrospinal fluid; Polymorphonuclear leukocytes; Monocyte