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Jeffrey Gruskay, MD; Mary Catherine Harris, MD; Andrew T. Costarino, MD; Richard A. Polin, MD; Stephen Baumgart, MD

Am J Dis Child. 1989;143(5):580-582.

Abstract
• 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 10x10⁶/L in 8 infants. Two subjects had CSF white blood cell counts of 11 x 10⁶/L and 14x10⁶/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.

(AJDC. 1989;143:580-582)

Author Affiliations
From the Division of Neonatology, The Children's Hospital of Philadelphia, the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia.

Footnotes
Accepted for publication December 20, 1988.

Reprint requests to Division of Neonatology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Baumgart).

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