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Etiology and laboratory abnormalities in bacterial meningitis in neonates and young infants

David Kotzbauer, Curtis Travers, Craig Shapiro, Margaux Charbonnet, Anthony Cooley, Deborah Andresen, Gary Frank
  • David Kotzbauer
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States | david.kotzbauer@choa.org
  • Curtis Travers
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States
  • Craig Shapiro
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States
  • Margaux Charbonnet
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States
  • Anthony Cooley
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States
  • Deborah Andresen
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States
  • Gary Frank
    Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, United States

Abstract

We conducted a retrospective review of electronic medical records of all cases of bacterial meningitis in neonates and young infants at our institution from 2004 to 2014. Fifty-six cases were identified. The most common causative organism was group B streptococcus, followed by Escherichia coli and then Listeria monocytogenes. Fortyfour of the 56 patients in the study had abnormalities of the blood white blood cell (WBC) count. The most common WBC count abnormalities were leukopenia and elevation of the immature to total (I:T) neutrophil ratio. Six patients in the case series lacked cerebrospinal fluid (CSF) pleocytosis. Overall, just 3 of the 56 patients had normal WBC count with differential, CSF WBC count, and urinalysis. Only 1 of the 56 patients was well appearing with all normal lab studies. Our study indicates that bacterial meningitis may occur without CSF pleocytosis but very infrequently occurs with all normal lab studies and well appearance.

Keywords

Bacterial meningitis; neonates; young infants; serious bacterial infection; laboratory abnormalities.

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Submitted: 2017-01-23 04:46:10
Published: 2017-04-21 10:21:23
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Copyright (c) 2017 David Kotzbauer, Curtis Travers, Craig Shapiro, Margaux Charbonnet, Anthony Cooley, Deborah Andresen, Gary Frank

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