What does a finding of pleocytosis indicate in the workup of viral meningitis?

Updated: Jul 17, 2018
  • Author: Cordia Wan, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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A retrospective multicenter study found that neither the presence nor quantity of immature neutrophils (bands) in CSF independently predicted bacterial meningitis among children with CSF pleocytosis. [11]

Pleocytosis with WBC counts in the range of 50 to more than 1000 x 109/L of blood has been reported in viral meningitis. Mononuclear cell predominance is the rule, but PMNs may make up most cells in the first 12-24 hours; the cell count is usually then dominated by lymphocytes in the classic CSF pattern of viral meningitis. This helps to distinguish viral from bacterial meningitis, which has a much higher cell count and a predominance of PMNs in the cell differential; this is by no means an absolute rule, however.

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