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Chu TT, Groh J, Cruz AT. Cerebrospinal fluid findings in infants with pertussis or parapertussis(1)). Clin Chem Lab Med. 2011;49(8):1341-1344doi: 10.1515/CCLM.2011.623.
Chu, T. T., Groh, J., & Cruz, A. T. (2011). Cerebrospinal fluid findings in infants with pertussis or parapertussis(1)). Clinical chemistry and laboratory medicine, 49(8), 1341-1344. https://doi.org/10.1515/CCLM.2011.623
Chu, Tina T, et al. "Cerebrospinal fluid findings in infants with pertussis or parapertussis(1))." Clinical chemistry and laboratory medicine vol. 49,8 (2011): 1341-1344. doi: https://doi.org/10.1515/CCLM.2011.623
Chu TT, Groh J, Cruz AT. Cerebrospinal fluid findings in infants with pertussis or parapertussis(1)). Clin Chem Lab Med. 2011 Aug;49(8):1341-1344. doi: 10.1515/CCLM.2011.623. Epub 2011 Jun 13. PMID: 21663570.
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Clin Chem Lab Med. 2011 Aug;49(8):1341-1344. doi: 10.1515/CCLM.2011.623. Epub 2011 Jun 13.

Cerebrospinal fluid findings in infants with pertussis or parapertussis(1)).

Clinical chemistry and laboratory medicine

Tina T Chu, Jesse Groh, Andrea T Cruz

Affiliations

  1. Department of Pediatrics, Baylor College of Medicine, Houtson, TX, USA.

PMID: 21663570 DOI: 10.1515/CCLM.2011.623

Abstract

BACKGROUND: Pertussis has been increasing in frequency and can cause protean manifestation in infants, often resulting in extensive laboratory evaluation.

METHODS: We examined the prevalence of cerebrospinal fluid (CSF) anomalies in infants with pertussis and parapertussis over a 5-year period.

RESULTS: In total, 239 of 1489 children (16.1%) had a positive PCR for pertussis or parapertussis. Eighty-three percent were infants; the mean age of the 39 years who received a lumbar puncture (LP) was 43 days. Reasons for performing LP included apnea (62%), toxic appearance (38%), fever (26%), and altered mentation (10%); several had >1 indication for LP. Twenty-four (62%) children had elevated CSF protein. No child had hypoglycorrhachia, bacterial meningitis, bacteremia, or intracranial hemorrhage; one child had a urinary tract infection and five had pneumonia. Seven children had brain imaging performed; one had a subarachnoid hemorrhage and six had normal studies. Elevated age-normalized CSF protein was a common finding in infants with pertussis, potentially due to transfer across a damaged or immature blood-brain barrier. This finding was seen in the absence of concomitant bacterial infections or detectable intracranial anomalies.

CONCLUSIONS: While the diagnostic evaluation and clinical management of a toxic-appearing infant should not be limited by a positive pertussis or parapertussis PCR, it is useful for physicians to be cognizant that elevated CSF protein can be seen in association with these infections.

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