Enteroviral and herpes simplex virus central nervous system infections in infants < 90 days old: a Paediatric Investigators’ Collaborative Network on Infections in Canada (PICNIC) study

Table 2 Comparison of initial cerebrospinal fluid findings in infants with HSV and EV central nervous system infections by univariate analysis

Parameter	Cerebrospinal (CSF) Findings	HSV N = 7	EV N = 100^a	P-Value^b
CSF white blood cell count	CSF white blood cell (WBC) (× 10⁶/L) at diagnosis, median (IQR)	26 (2–146)	153 (17.5–422)	0.08
	CSF WBC, n (%)
	> 9 × 10⁶/L	4 (57)	79 (79)	0.18
	> 15 × 10⁶/L	4 (57)	76 (76)	0.37
	> 100 × 10⁶/L	3 (43)	57 (57)	0.70
	> 500 × 10⁶/L	0	22 (22)	0.34
	> 1000 × 10⁶/L^c	0	10 (10)	1.00
	> 2000 × 10⁶/L^d	0	6 (6)	1.00
	Median percentage polymorphonuclear contribution to CSF cell count	6 (3–14)	25 (6–51)	0.04
	CSF pleocytosis^e	4 (57)	77 (77)	0.36
	CSF cell count with polymorphonuclear dominance (> 50%), n (%)	0/7 (0)	23/86 (27)	0.19
CSF red blood cell count	CSF red blood cell count (×10⁶/L), median (IQR)	26 (1–6950)	23 (2–138)	0.66
CSF glucose	CSF glucose (mmol/L), median (IQR)	2.4 (2.1–2.8)	2.4 (2.2–2.7)	0.90
CSF glucose	CSF glucose < 2.1 mmol/L^c, n (%)	0/7 (0)	10 (10)	0.91
CSF protein	CSF protein (g/L), median (IQR)	0.76 (0.53–0.90)	0.79 (0.59–1.02)	0.86
CSF protein	Protein > 1 g/L^c, n (%)	1 (14)	25/98 (25)	0.68

Legend: CSF cerebrospinal fluid, HSV herpes simplex virus, IQR interquartile range, WBC white blood cell count
^aThree of the EV cases had CSF sent only for microbiological analysis; so only 100 cases had CSF analysis that included a cell count, protein or glucose level; 2/7 (29%) of the EV cases that were classified as meningoencephalitis had CSF WBC < 30 × 10⁶/L
^bFor comparison of proportions, Fishers exact test (2-sided) was used; for comparison of medians, Mann-Whitney test was used
^c EV cases were more likely than HSV cases to have one or more of the parameters (cell count > 1000 × 10⁶/L, Glucose < 2.0 mmol/L and CSF Protein > 1.0 g/L. ≥1) that suggested bacterial meningitis (65 (64%) versus 1 (13%); p = 0.006)
^d EV cases with CSF WBC > 2000 × 10⁶/L had median CSF WBC of 2630 (range 2020–6400) × 10⁶/L
^e CSF pleocytosis was defined as CSF white cell count > 15 × 10⁶/L for infants 0–28 days of age and > 9 × 10⁶/L for infants beyond neonatal period. ⁶ Of 74 neonates with spinal taps, 22 (30%) neonates had CSF WBC < 15 × 10⁶/L and 4/33 (12%) infants >28d old had CSF WBC < 9 × 10⁶/L

ISSN: 1471-2431