Is 15 WBC in CSF Normal? Age-Specific Norms

March 28, 2018

Spoon Feed
Normal CSF looks different in neonates and infants 29-60 days. Here are the reference values.

Why does this matter?
Normally, 15 WBCs in CSF would be considered a pleiocytosis, but not in a neonate.  So what is normal?  Cells and protein are higher; glucose is lower.

Adults are not just large neonates…well most of them
This was a large, multi-center study of over 22,000 infants 0-60 days who had CSF sampled.  After excluding those who may have had disease which could alter CSF, 7766 remained.  They found the following normal values for infant CSF.

• Neonate, 0-28 days: WBC upper limit 15 cells/mm3; protein 127mg/dL; glucose 25mg/dL
• 29-60 days: WBC upper limit 9 cells/mm3; protein 99mg/dL; glucose 27mg/dL

Source
Cerebrospinal Fluid Reference Values for Young Infants Undergoing Lumbar Puncture.  Pediatrics. 2018 Feb 2. pii: e20173405. doi: 10.1542/peds.2017-3405. [Epub ahead of print]

Peer reviewed by Thomas Davis, MD.