Cerebrospinal fluid pleocytosis and urinary tract infections

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In a subanalysis of prospective evaluations of 1025 infants ≤60 days of age seen in 8 pediatric Emergency Departments in the US, Shah et al report on 91 infants who were confirmed to have urinary tract infection. In 82 of these infants who also had CSF examined, 18.5% had pleocytosis and sterile CSF, which was not different from those (19.3%) who did not have UTI. When infants with pleocytosis in whom there was evidence of traumatic lumbar puncture (>1000 red blood cells/mm³) were excluded, 0% to 8% (depending on the definition of pleocytosis used) had unexplained pleocytosis. These data do not support a previously reported independent association of UTI and CSF pleocytosis.