CSF WBC Correction In Blood Contaminated CSF

Correction equation for white cell count in setting of traumatic lumbar puncture

Questions

1.Reported CSF White Blood Cell (WBC) count
2.Reported peripheral blood WBC count
3.Reported CSF Red Blood Cell (RBC) count
4.Reported peripheral blood RBC count

About

Lumbar puncture is an important procedure to access and assess cerebrospinal fluid (CSF). Traumatic lumbar puncture is a common inadvertent consequence whereby peripheral blood is introduced into the CSF thereby distorting the true cell counts. The CSF correction of white blood cell count (WBC) equation was derived to reflect the true CSF WBC count through accounting for and excluding contributions from the peripheral blood.

To date there is no evidence that use of this formula can fully exclude meningitis, one of the primary indications to perform a lumbar puncture. As a result, many experts advocate for interpretation of the WBC without a corrective measure - as a more conservative estimate for CSF composition.

Calculator for CSF WBC Correction

  • Corrected WBC = Reported CSF WBC - [(WBC in peripheral blood x RBC in CSF) / (RBC in peripheral blood)]
  • WBC = White blood cell
  • RBC = Red blood cell
  • CSF = Cerebrospinal fluid

Units here are reported in cells / mm3, however so long as units remain consistent across the variables in the equation you can use values that are reported by your local lab.

References

Greenberg RG, Smith PB, Cotton CM, Moody MA, Clark RH, Benjamin DK.

Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count.

Pediatr Infect Dis J. 2008 Dec;27(12):1047-51.

The CSF WBC Correction In Blood Contaminated CSF calculator is created by QxMD.

Created by on 16/09/2019

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1. Reported CSF White Blood Cell (WBC) count

cells / mm³
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