Hematologic parameters to predict negative cerebrospinal fluid examination results among neurologically intact patients who underwent lumbar puncture on suspicion of central nervous system infection

• DOI: 10.15441/ceem.16.152
• Publication Date: 2017-03-31T01:23:09Z
• Authors: Ji Hwan Kim; Hong-Jik Kim; Ji Ung Na; Sang Kuk Han; Pil Cho Choi; Dong Hyuk Shin
• Keywords: Pleocytosis; White blood cell; Leukocytosis; Monocyte; Neurological examination

Cerebrospinal fluid (CSF) examination is mandatory whenever central nervous system (CNS) infection suspected. However, pleocytosis not detected in a substantial number of suspected patients who undergo CSF examination. This study aimed to identify parameters that can aid predicting negative results (defined as white blood cell count <5 cells/high-power field).The included 101 neurologically intact underwent lumbar puncture because suspicion CNS infection. Patients were divided into and positive groups, their initial tests comparatively analyzed.The group had significantly higher proportion neutrophils cells (81.5% vs. 75.8%, P=0.012), lower lymphocytes (9.3% 16.7%, P=0.001), neutrophil-to-lymphocyte ratio (9.1 4.4, lymphocyte-to-monocyte (1.6 2.4, P=0.008), C-reactive protein level (21.0 5.0 mg/L, P<0.001) than the group. In receiver-operating characteristic analysis, an area under curve >0.7, best cutoff values 6.0 (accuracy 70.3%) 12.7 mg/L 76.2%), respectively.The ≥6 ≥12.7 was associated with result.