All issues > Volume 31(6); 1988

Original Article

J Korean Pediatr Soc. 1988;31(6):707-714. Published online June 30, 1988.

Cerebrospinal Fluid Lymphocytosis in Acute Bacterial Meningitis on Children.

Hong Kun Kim¹, Woo Gill Lee¹

¹Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea

Received: December 28, 1987;  Accepted: December 28, 1987.

Abstract

Clinical and laboratory analysis of 78 cases of acute bacterial meningitis diagnosed by cere- brospinal (CSF) culture under 15 years old was made, retrospectively from Jan. 1973 to Dec. 1986, who were admitted to the Department of Pediatrics Hanyang University Hospital. The results analysed were as follows: 1) CSF lymphocytosis (more than 50% lymphocytes or mononuclear cells)occurred in 18 of 78 cases (23%) of bacterial meningitis. 2) There were no significant difference between Group A (18 cases CSF lymphocytosis) and Group B (60 cases CSF polymorphonuclear cell dominant) in distribution of age and sex, clinical manifesta- tions on admission, etiologic organisms, predisposing factors, feature of peripheral blood and protein level of CSF. 3) Patients with CSF lymphocytosis accounted for 34% (13 of 38 cases) of patients with bacterial meningitis with a CSF white blood cell concentration of less than 1,000/mm³, which was significantly much higher than 13% (5 of 40 cases) of patients with a CSF white blood cell count of 1,000/mm³ or more (p<0.05). 4) Although sugar level of CSF in 76% of all patients with bacterial meningitis was 39 mg/dl or less, 67% of the sugar level of CSF in Group A were within normal limit which was considerable difference (p< 0.005) compare to Group B (12%). 5) The mortality of 78 patients with bacterial meningitis was 31%. There was significant difference (p<0.005) between Group A (17%) and B (35%) in mortality. Therefore, the prognosis of patients with bacterial meningitis with CSF lymphocytosis, normal sugar level of CSF and CSF white blood cell concentration of less than 1,000/mm³ was better than patients with CSF polymorphonuclear cell dominant, reduced sugar level of CSF and CSF white blood cell concentration of 1,000/mm³ or more.

Keywords :Bacterial meningitis, CSF lymphocytosis