Neonatal Staphylococcus epidermidis meningitis with unremarkable CSF examination results
J. Gruskay, M. C. Harris, A. T. Costarino, R. A. Polin and S. Baumgart
Division of Neonatology, Children's Hospital of Philadelphia, PA 19104.
We identified 10 infants (mean +/- SD birth weight, 1000 +/- 500 g;
gestation, 29 +/- 3 weeks; postnatal age, 24 +/- 19 days) who had
Staphylococcus epidermidis meningitis despite unremarkable cerebrospinal
fluid (CSF) blood cell counts and glucose and protein levels.
Staphylococcus epidermidis meningitis was diagnosed if all the following
criteria were satisfied: (1) a CSF culture positive for S epidermidis
within 48 hours, (2) a blood culture positive for S epidermidis with
antibiotic sensitivities identical to those of the CSF isolate, and (3)
clinical symptomatology. Lumbar puncture yielded white blood cell counts
lower than 10 x 10(6)/L in 8 infants. Two subjects had CSF white blood cell
counts of 11 x 10(6)/L and 14 x 10(6)/L. Cerebrospinal fluid glucose (2.8
+/- 0.9 mmol/L) and protein (1.15 +/- 0.32 g/L) concentrations were also
unremarkable. Infants were treated with parenteral antibiotics for 19 +/- 5
days. There was no mortality or short-term morbidity. Staphylococcus
epidermidis is a recognized cause of nosocomial meningitis in
low-birth-weight infants and frequently occurs without CSF abnormalities.
