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- Title
Cerebrospinal fluid pleocytosis level as a diagnostic predictor? A cross-sectional study.
- Authors
Østergaard, Anne Ahrens; Sydenham, Thomas Vognbjerg; Nybo, Mads; Andersen, Åse Bengård
- Abstract
Background: Lumbar puncture with quantification of leukocytes and differential count of cellular subsets in the cerebrospinal fluid is a standard procedure in cases of suspected neuroinfectious conditions. However, a number of non-infectious causes may result in a low leukocyte number (0-1000 cells/ml). We wanted to assess the diagnostic diversity of unselected adult patients with pleocytosis in the cerebrospinal fluid. Methods: The study is based on data from cerebrospinal fluid (CSF) analyses of all adult patients (15 years or older) admitted to a large university hospital in Denmark during a two-year period (2008-2009). Data from the local patient administrative system supplied with data from patient charts were combined with laboratory data. Results: A total of 5390 cerebrospinal fluid samples from 3290 patients were included. Pleocytosis >5 leucocytes/µl was found in samples from 262 patients of which 106 (40.5%) were caused by infection of the central nervous system (CNS), 20 (7.6%) by infection outside CNS, 79 (30.2%) due to non-infectious neurological diseases, 23 (8.8%) by malignancy, and 34 (13.0%) caused by other conditions. Significantly higher mean CSF leukocytes was found in patients suffering from CNS infection (mean 1135 cells/µl, p-value <0.0001). Conclusions: CNS infection, non-infectious neurological disease, malignancy, and infection outside CNS can cause pleocytosis of the cerebrospinal fluid. Leukocyte counts above 100/µl is mainly caused by CNS infection, whereas the number of differential diagnoses is higher if the CSF leukocyte counts is below 50/µl. These conditions are most commonly caused by non-infectious neurological diseases including seizures.
- Subjects
CEREBROSPINAL fluid; LEUCOCYTES; LUMBAR puncture; SPASMS; CENTRAL nervous system infections; PHYSIOLOGY
- Publication
BMC Clinical Pathology, 2017, Vol 17, Issue 1, p1
- ISSN
1472-6890
- Publication type
Article
- DOI
10.1186/s12907-017-0053-0