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Persistent pleocytosis in bacterial meningitis

S A Chartrand, C T Cho

    The Journal of Pediatrics
    |March 1, 1976
    PubMed

    Insights

    Persistent pleocytosis, an elevated white blood cell count in cerebrospinal fluid, is common in children treated for bacterial meningitis. This finding alone does not warrant extending treatment duration for meningitis.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Neurology

    Background:

    • Bacterial meningitis requires prompt antibiotic treatment.
    • Cerebrospinal fluid (CSF) analysis is crucial for diagnosis and monitoring.
    • Persistent pleocytosis can complicate treatment assessment.

    Purpose of the Study:

    • To investigate the incidence of persistent pleocytosis in children treated for bacterial meningitis.
    • To determine if persistent pleocytosis indicates a need for prolonged therapy.

    Main Methods:

    • Retrospective analysis of pediatric patients diagnosed with bacterial meningitis.
    • Evaluation of CSF white blood cell counts post-treatment initiation.
    • Categorization based on causative pathogen (e.g., Hemophilus influenzae, Streptococcus pneumoniae).

    Main Results:

    • Persistent pleocytosis (>60 cells/mm3) was observed in 62% of children with Hemophilus influenzae meningitis (13/21).
    • 22% of children with pneumococcal meningitis (2/9) showed persistent pleocytosis.
    • No clear correlation was established between persistent pleocytosis and the need for extended therapy.

    Conclusions:

    • Persistent pleocytosis is a frequent finding in children adequately treated for bacterial meningitis.
    • Pleocytosis alone is insufficient evidence to prolong antibiotic therapy for bacterial meningitis.
    • The clinical significance of persistent pleocytosis in treated bacterial meningitis remains undetermined.

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