The clinical significance of neutrophilic pleocytosis in cerebrospinal fluid in patients with viral central nervous system infections
| Autor: | Susan H. Wootton, Rodrigo Hasbun, Elizabeth Aguilera, Siraya Jaijakul, Lucrecia Salazar |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Enterovirus infection
Adult Male 0301 basic medicine Microbiology (medical) Adolescent Leukocytosis Neutrophils 030106 microbiology Lymphocytic pleocytosis lcsh:Infectious and parasitic diseases 03 medical and health sciences Central Nervous System Infections 0302 clinical medicine Cerebrospinal fluid Herpes infection Arbovirus infection Enterovirus Infections medicine Viral meningitis Humans lcsh:RC109-216 Clinical significance Lymphocytes 030212 general & internal medicine Respiratory system Pleocytosis Retrospective Studies business.industry Community-acquired CNS infections Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Neutrophilic pleocytosis Infectious Diseases Immunology Female business Encephalitis |
| Zdroj: | International Journal of Infectious Diseases, Vol 59, Iss C, Pp 77-81 (2017) |
| ISSN: | 1201-9712 |
| Popis: | Summary Background Viral central nervous system (CNS) infections are typically characterized by a cerebrospinal fluid (CSF) lymphocytic pleocytosis. A CSF neutrophilic pleocytosis presentation has been described, but its prognostic and clinical significance is unknown. The objectives of this study were to (1) compare the clinical and laboratory characteristics of viral CNS infections with a CSF neutrophilic pleocytosis to those with a lymphocytic pleocytosis, and (2) evaluate factors associated with an adverse clinical outcome. Methods A retrospective study of patients with confirmed viral CNS infections was conducted. The patients were divided into those with CSF neutrophilic pleocytosis and those with CSF lymphocytic pleocytosis. Clinical findings and outcomes were compared between the two groups. Results Of the 182 patients included in the study, 45 (24.7%) had CSF neutrophilic pleocytosis. Enterovirus infections were the cause of 64% of neutrophil-predominant CSF and 33% of lymphocyte-predominant CSF ( p 0.001), while herpes infections were the cause of 46% of lymphocytic pleocytosis and 20% of neutrophilic pleocytosis ( p =0.003). Moreover, neutrophilic pleocytosis was seen more commonly in younger patients ( p =0.001), patients with respiratory symptoms ( p =0.04), and patients with higher CSF white cell counts ( p =0.004). Twenty-nine patients had an adverse clinical outcome (15.9%); the only predictor independently associated with an adverse clinical outcome on multivariable logistic regression analysis was an encephalitis presentation ( p =0.01). Conclusions The results of a study exploring the association between CSF neutrophilic pleocytosis and clinical and prognostic significance are presented here. This study suggests that CSF neutrophilic pleocytosis is not associated with higher adverse clinical outcomes. |
| Databáze: | OpenAIRE |
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