This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

RAN D. ANBAR, MD
Children's Service Massachusetts General Hospital 32 Fruit St Boston, MA 02114

Am J Dis Child. 1986;140(8):737-738.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Sir.—A traumatic lumbar puncture obscures the cerebrospinal fluid's original white blood cell (WBC) count. According to recent publications,^1-3 the calculation for estimating the contribution of contaminating peripheral blood to the total WBC count of a traumatic spinal tap can be represented as follows: WBC_{contaminating} = RBC_CSF x WBC_peripheral/RBC_peripheral, in which RBC indicates red blood cells and CSF indicates cerebrospinal fluid. The following discussion demonstrates that the proposed calculation does not permit the clinician to rule out meningitis, which is defined as six or more leukocytes per cubic millimeter (x10⁶/L) in the CSF.¹

If the patient's peripheral WBC/RBC ratio is estimated (published estimates range from 1/300 to 1/700^2-4), the calculated contaminating WBC count may vary by more than 100% depending on the ratio used. Table 1 illustrates the different clinical conclusions that could result. Therefore, estimated ratios should not be . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?