[Skip to Navigation]
September 1986

Infants With Meningitis Without Cerebrospinal Fluid Pleocytosis

Author Affiliations

Division of Allergy/Immunology Department of Pediatrics Children's Hospital Medical Center Elland and Bethesda avenues Cincinnati, OH 45229
Department of Pediatrics Box J-296 J. Hillis Miller Medical Center University of Florida College of Medicine Gainesville, FL 32610

Am J Dis Child. 1986;140(9):851. doi:10.1001/archpedi.1986.02140230021007

Sir.—We recently cared for two infants with clinical signs of meningitis without cerebrospinal fluid (CSF) pleocytosis. However, cultures were positive within 24 hours for Haemophilus influenzae in one infant and β-hemolytic Streptococcus group B in the other. We report these cases to warn physicians that meningitis may occur in the absence of CSF pleocytosis, even in otherwise healthy and normal children.

Patient Reports.—Patient 1.—An 8-month-old black male infant was in good health until three days prior to admission, when lethargy, decreased appetite, 38.4°C temperature, and "twitching movements" that lasted about ten minutes developed. The patient had nuchal rigidity, a grade 1/6 soft systolic murmur, and diffuse rales in both lung fields. Brudzinski's and Kernig's signs were negative. Results of admission laboratory tests, including a complete blood cell count, were normal. Hemoglobin electrophoresis showed hemoglobin A only. Serum immunoglobulins, total serum hemolytic complement, neutrophil chemotaxis, and chemoluminescence were

Add or change institution