The Journal of infectious diseases
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The characteristics of cerebrospinal fluid (CSF) associated with traumatic lumbar puncture, defined as CSF red blood cell (RBC) count greater than 1000/mm3, were reviewed in 92 previously healthy children greater than 1 month of age; 30 had bacterial meningitis and 62 had negative CSF cultures. The purpose was to distinguish CSF profiles of the two groups despite contamination with peripheral blood elements. ⋯ Significant differences were observed in the rate of O:P ratio greater than or equal to 1 (100% vs. 32%), CSF differential cell count predominance of polymorphonuclear leukocytes (97% vs. 11%), hypoglycorrhachia (73% vs. 3%), and positive Gram's-stained smear for pathologic organisms (80% vs. 0) in those with and without bacterial meningitis, respectively (P less than .0001). Thus, in children greater than 1 month of age, CSF abnormalities associated with bacterial meningitis are rarely obscured by blood contamination from traumatic lumbar puncture.