CEREBROSPINAL FLUID FINDINGS IN NEONATAL BACTERIAL MENINGITIS

Background : Meningitis is more common during the neonatal period than other periods of life and has a prevalence of one in 1000 live births. The similarity of its clinical manifestations with other infectious diseases makes it difficult to diagnose. The aim of the current study was to determine the relationship between age, sex, clinical signs and symptoms and laboratory test results of newborns in which bacterial meningitis had been confirmed by positive CSF culture. Methods: This cross-sectional study was performed by a non-randomized simple sampling method, in which the medical files of neonates hospitalized between March 1994 and Oct. 1999 were reviewed. Results: A total of294 files (16 boys, 127 girls 54 preterm, 240 full-term infants) were reviewed. Fifteen newborns (8 girls, 7 boys) had positive CSF culture results. A significant statistical relationship was not found between sex and pre-term cases with meningitis. The most common results in newborns with positive CSF culture were poor feeding, lethargy and hyperthermia, followed by seizures, jitteriness, hypothermia and vomiting. Blood culture was positive in only 6 (40%) of the 15 neonates with positive CSF cultures. Leukocytosis (3 cases, 20%), thrombocytopenia (2 cases, 13 .3%) and positive direct CSF smear (9 cases, 60%) were also present. Group B Streptococcus (GBS), E. coli and gram-negative bacteria were the leading causes of neonatal sepsis and meningitis. A significant difference was found in the WBC count, CSF protein and glucose levels with bacterial meningitis. A significant relationship was also found to exist between CSF glucose-simultaneous blood glucose ratio and neonatal meningitis. Conclusion: There was a significant difference between CSF protein and glucose, WBC count and bacterial meningitis. A significant relationship was also found between CSF and blood glucose ratio ( CG ) and neonatal bacterial meningitis