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Publication Date:
June 2008
ISSN:
1437-4331
DOI:
10.1515/CCLM.2008.167

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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the International Federation of Clinical Chemistry and Laboratory Medicine and the European Federation of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Lippi, Giuseppe / Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Melichar, Bohuslav / Siest, Gérard / Whitfield, John B. / Abi Fadel, Marianne / Alvarez Menendez, Francisco V. / Azzazy, Hassan M.E. / Diamandis, Eleftherios P. / Eckardstein, Arnold / Favaloro, Emmanuel J. / Griesmacher, Andrea / Herrmann, Wolfgang / Hoffmann, Johannes J.M.L. / Hooijkaas, Herbert / Ichihara, Kiyoshi / Kaabachi, Naziha / Kim, Jeong-Ho / Korte, Wolfgang / Kroupis, Christos / Lai, Leslie Charles / Lam, Wai Kei Christopher / Marc, Janja / Miyoshi, Eiji / Özben, Tomris / Palicka, Vladimir / Panteghini, Mauro / Queralto, Jose M. / Scartezini, Marileia / Simundic, Ana-Maria / Tsongalis, Gregory J. / Wallemacq, Pierre E. / Yan, Shengkai / Young, Ian S. / Chiu, Rossa Wai Kwun / Ghosh, Debabrata / Kappelmayer, Janos / Lehmann, Sylvain / Sypniewska, Grazyna

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Correction of ventricular cerebrospinal fluid (CSF) samples for blood content does not increase sensitivity and specificity for the detection of CSF infection

Klas Boeer1 / Robert Siegmund2 / Wolfgang Pfister3 / Stefan Isenmann4 / Thomas Deufel5

1Institut für Klinische Chemie und Laboratoriumsdiagnostik, Friedrich Schiller University, Jena, Germany

2Institut für Klinische Chemie und Laboratoriumsdiagnostik, Friedrich Schiller University, Jena, Germany

3Institut für Medizinische Mikrobiologie, Friedrich Schiller University, Jena, Germany

4Klinik für Neurologie und Klinische Neurophysiologie, Helios Klinkum Wuppertal und Universität Witten/Herdecke, Germany and Klinik für Neurologie, Friedrich Schiller University, Jena, Germany

5Institut für Klinische Chemie und Laboratoriumsdiagnostik, Friedrich Schiller University, Jena, Germany

Corresponding author: Dr. Klas Boeer, Institut für Klinische Chemie und Laboratoriumsdiagnostik, Erlanger Allee 101, 07740 Jena, Germany

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 46, Issue 6, Pages 842–848, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2008.167, June 2008

Publication History:
Received:
2007-10-15
Accepted:
2008-02-14
Published Online:
2008-06-09

Abstract

Background: Blood contamination is commonly observed in ventricular cerebrospinal fluid (CSF) samples from patients with extraventricular drainage systems. Because the introduction of blood may interfere with the white blood cell count as a useful marker for the diagnosis of an infection, correction for blood content would be desirable.

Methods: In a retrospective study, we analysed the use of correction formulas in 724 blood-contaminated ventricular CSF samples.

Results: Using a standard correction method the white blood cell count was not normalised in most CSF samples, with pleocytosis indicating an inflammatory stimulus set by the blood itself or by the foreign body. When correcting white blood cell counts in the CSF of culture-positive patients, some samples were normalised or overcorrected. In addition, correction of the CSF white blood cell count did not increase sensitivity and specificity for the detection of culture-positive CSF samples.

Conclusions: Correction is not necessary when using the white blood cell count as a parameter to predict CSF infection in ventricular CSF samples.

Clin Chem Lab Med 2008;46:842–8.

Keywords: blood contamination; cerebrospinal fluid; correction; infection

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