Table 2.
Comparison of initial cerebrospinal fluid findings in infants with HSV and EV central nervous system infections by univariate analysis
| Parameter | Cerebrospinal (CSF) Findings | HSV N = 7 | EV N = 100a | P-Valueb |
|---|---|---|---|---|
| CSF white blood cell count | CSF white blood cell (WBC) (× 106/L) at diagnosis, median (IQR) | 26 (2–146) | 153 (17.5–422) | 0.08 |
| CSF WBC, n (%) | ||||
| > 9 × 106/L | 4 (57) | 79 (79) | 0.18 | |
| > 15 × 106/L | 4 (57) | 76 (76) | 0.37 | |
| > 100 × 106/L | 3 (43) | 57 (57) | 0.70 | |
| > 500 × 106/L | 0 | 22 (22) | 0.34 | |
| > 1000 × 106/Lc | 0 | 10 (10) | 1.00 | |
| > 2000 × 106/Ld | 0 | 6 (6) | 1.00 | |
| Median percentage polymorphonuclear contribution to CSF cell count | 6 (3–14) | 25 (6–51) | 0.04 | |
| CSF pleocytosise | 4 (57) | 77 (77) | 0.36 | |
| CSF cell count with polymorphonuclear dominance (> 50%), n (%) | 0/7 (0) | 23/86 (27) | 0.19 | |
| CSF red blood cell count | CSF red blood cell count (×106/L), median (IQR) | 26 (1–6950) | 23 (2–138) | 0.66 |
| CSF glucose | CSF glucose (mmol/L), median (IQR) | 2.4 (2.1–2.8) | 2.4 (2.2–2.7) | 0.90 |
| CSF glucose < 2.1 mmol/Lc, n (%) | 0/7 (0) | 10 (10) | 0.91 | |
| CSF protein | CSF protein (g/L), median (IQR) | 0.76 (0.53–0.90) | 0.79 (0.59–1.02) | 0.86 |
| Protein > 1 g/Lc, n (%) | 1 (14) | 25/98 (25) | 0.68 |
Legend: CSF cerebrospinal fluid, HSV herpes simplex virus, IQR interquartile range, WBC white blood cell count
aThree of the EV cases had CSF sent only for microbiological analysis; so only 100 cases had CSF analysis that included a cell count, protein or glucose level; 2/7 (29%) of the EV cases that were classified as meningoencephalitis had CSF WBC < 30 × 106/L
bFor comparison of proportions, Fishers exact test (2-sided) was used; for comparison of medians, Mann-Whitney test was used
c EV cases were more likely than HSV cases to have one or more of the parameters (cell count > 1000 × 106/L, Glucose < 2.0 mmol/L and CSF Protein > 1.0 g/L. ≥1) that suggested bacterial meningitis (65 (64%) versus 1 (13%); p = 0.006)
d EV cases with CSF WBC > 2000 × 106/L had median CSF WBC of 2630 (range 2020–6400) × 106/L
e CSF pleocytosis was defined as CSF white cell count > 15 × 106/L for infants 0–28 days of age and > 9 × 106/L for infants beyond neonatal period. 6 Of 74 neonates with spinal taps, 22 (30%) neonates had CSF WBC < 15 × 106/L and 4/33 (12%) infants >28d old had CSF WBC < 9 × 106/L