Interpretation of Traumatic Lumbar Puncture in Aseptic Meningitis / 소아과

ABSTRACT

PURPOSE: This study was undertaken to find out a useful method that can predict the true leukocytosis in blood-contaminated cerebrospinal fluid(CSF) due to traumatic lumbar puncture(LP), using white and red cell counts of sanguineous CSF and peripheral blood. METHODS: From May 2001 to December 2002, among 1,247 patients presenting symptoms of meningitis who had received LP at Chonnam Hospital, 126 patients were included in this study who had undergone a second LP due to a traumatic first one. According to the final results of second LP, they were devided into two groups, aseptic meningitis group; and normal CSF group. Medical records were reviewed retrospectively, the proportions of white blood cells to red blood cells were obtained in the peripheral blood(WBC:RBCBlood) and CSF(WBC:RBCCSF), based on the results of the traumatic first LP and simultaneously performed peripheral blood count. The WBC:RBCCSF/WBC:RBCBlood ratio was calculated in each patient. RESULTS: The WBC:RBCCSF/WBC:RBCBlood of the normal CSF group was 13.5+/-7.3(standard deviation), significantly lower than 47.3+/-39.5 of the aseptic meningitis group. CONCLUSION: The WBC:RBCCSF/WBC:RBCBlood is a useful value to predict frank leukocytosis in the blood-contaminated CSF due to traumatic LP, but all clinical and laboratory informations must be considered before deciding on a treatment strategy to minimize the risk of misdiagnosis.