Cerebrospinal fluid studies in an intensive care nursery

Prospective and retrospective data were collected from 394 cerebrospinal fluid (CSF) examinations performed in premature and full term infants in a neonatal intensive care unit from October, 1969, to April, 1973.Premature infants had an average of 6 WBCs/mn and 180 mg/100 ml protein in their CSF in the first week, and 3 WBCs/mm and 117 mg/100 ml protein in the fourth week of life. Full term infants had an average of 5 WBCs/mm and 117 mg/100 ml protein in the CSF during their first week, and 5 WVCs/mm and 74 mg/100ml protein in their fourth week of life. Thus, increasing age at the time of lumbar puncture was associated with decreased cell number and lower protein in the CSF. Infants with bacterial meningitis, intracranical hemorrhage and those born of diabetic mothers had the highest values of CSF protein and WBCs. The highest number of RBCs in the CSF was seen in infants with intracranial hemorrhage and infants born of diabetic mothers. Fifteen (4%) of the 394 CSFs examined yielded a virus or bacteria: 5 E. coli, 6 group B beta hemolytic streptococci, and 1 each a pneumococcus, cytomegalo-virus, Coxsackie, and ECHO virus. The CSF findings in the population of infants afflicted with the variety of illnesses studied are not strikingly different from published "normals". Thus, some degree of patient heterogeneity must have been present in previous series.