Pathogen detection in acellular cerebrospinal fluid: diagnostic insights from a pediatric cohort in Colombia

This study challenges the long-standing paradigm that abnormal cerebrospinal fluid (CSF) findings are required to justify molecular testing in pediatric meningoencephalitis. We show that critical central nervous system (CNS) infections can present with entirely normal CSF profiles, including cases caused by high-risk pathogens such as <i>E. coli</i> K1 and <i>Streptococcus agalactiae</i>. By highlighting the limitations of pleocytosis and biochemical markers in detecting early CNS infection, our data underscore the importance of incorporating molecular diagnostics into routine clinical evaluation, particularly for high-risk pediatric populations. Failure to do so may result in missed or delayed diagnoses and suboptimal treatment.

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Publication Details

Journal
Microbiology Spectrum
Published
2025-11-24
DOI
https://doi.org/10.1128/spectrum.02122-25
Primary Topic
Bacterial Infections and Vaccines
Type
article
Field-Weighted Citation Impact
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Pathogen detection in acellular cerebrospinal fluid: diagnostic insights from a pediatric cohort in Colombia

Marcio De-Ávila-Arias, Wilfrido Coronell-Rodríguez, José Villarreal Camacho, Elber Osorio-Rodríguez et al.
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Pathogen detection in acellular cerebrospinal fluid: diagnostic insights from a pediatric cohort in Colombia

Marcio De-Ávila-Arias, Wilfrido Coronell-Rodríguez, José Villarreal Camacho, Elber Osorio-Rodríguez, Alexander Rodríguez, Jorge Bilbao Ramírez, Jhonny Jesús Patiño Patiño, Alfonso Bettin Martínez, Margarita Filott-Tamara, Yina Paola García Toscano, Walter Martínez De la Rosa
article en

Abstract

This study challenges the long-standing paradigm that abnormal cerebrospinal fluid (CSF) findings are required to justify molecular testing in pediatric meningoencephalitis. We show that critical central nervous system (CNS) infections can present with entirely normal CSF profiles, including cases caused by high-risk pathogens such as <i>E. coli</i> K1 and <i>Streptococcus agalactiae</i>. By highlighting the limitations of pleocytosis and biochemical markers in detecting early CNS infection, our data underscore the importance of incorporating molecular diagnostics into routine clinical evaluation, particularly for high-risk pediatric populations. Failure to do so may result in missed or delayed diagnoses and suboptimal treatment.

Microbiology SpectrumVol. 14(1)
University of Cartagena (CO), Universidad de Antioquia (CO), Universidad Metropolitana (CO), Institute for Biomedicine (IT), Iberoamerican University (CR), Universidad Metropolitana (NI), Universidad Metropolitana (PR)
Openalex Percentile: Top 66%
Bacterial Infections and Vaccines
DOIOpen Access PDFOpenAlex
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