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

From: 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

ParameterCerebrospinal (CSF) FindingsHSV N = 7EV N = 100aP-Valueb
CSF white blood cell countCSF white blood cell (WBC) (× 106/L) at diagnosis, median (IQR)26 (2–146)153 (17.5–422)0.08
CSF WBC, n (%)   
> 9 × 106/L4 (57)79 (79)0.18
> 15 × 106/L4 (57)76 (76)0.37
> 100 × 106/L3 (43)57 (57)0.70
> 500 × 106/L022 (22)0.34
> 1000 × 106/Lc010 (10)1.00
> 2000 × 106/Ld06 (6)1.00
Median percentage polymorphonuclear contribution to CSF cell count6 (3–14)25 (6–51)0.04
CSF pleocytosise4 (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 countCSF red blood cell count (×106/L), median (IQR)26 (1–6950)23 (2–138)0.66
CSF glucoseCSF glucose (mmol/L), median (IQR)2.4 (2.1–2.8)2.4 (2.2–2.7)0.90
CSF glucose < 2.1 mmol/Lc, n (%)0/7 (0)10 (10)0.91
CSF proteinCSF protein (g/L), median (IQR)0.76 (0.53–0.90)0.79 (0.59–1.02)0.86
Protein > 1 g/Lc, n (%)1 (14)25/98 (25)0.68
  1. Legend: CSF cerebrospinal fluid, HSV herpes simplex virus, IQR interquartile range, WBC white blood cell count
  2. 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
  3. bFor comparison of proportions, Fishers exact test (2-sided) was used; for comparison of medians, Mann-Whitney test was used
  4. 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)
  5. d EV cases with CSF WBC > 2000 × 106/L had median CSF WBC of 2630 (range 2020–6400) × 106/L
  6. 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