The role of lumbar puncture in children with suspected central nervous system infectionReport as inadecuate




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BMC Pediatrics

, 2:8

First Online: 02 September 2002Received: 20 May 2002Accepted: 02 September 2002

Abstract

BackgroundThe use of the lumbar puncture in the diagnosis of central nervous system infection in acutely ill children is controversial. Recommendations have been published but it is unclear whether they are being followed.

MethodsThe medical case notes of 415 acute medical admissions in a children-s hospital were examined to identify children with suspected central nervous system infection and suspected meningococcal septicaemia. We determined whether lumbar punctures were indicated or contraindicated, whether they had been performed, and whether the results contributed to the patients- management.

ResultsFifty-two children with suspected central nervous system infections, and 43 with suspected meningococcal septicaemia were identified. No lumbar punctures were performed in patients with contraindications, but only 25 53% of 47 children with suspected central nervous system infection and no contraindications received a lumbar puncture. Lumbar puncture findings contributed to the management in 18 72% of these patients, by identifying a causative organism or excluding bacterial meningitis.

ConclusionThe recommendations for undertaking lumbar punctures in children with suspected central nervous system infection are not being followed because many children that should receive lumbar punctures are not getting them. When they are performed, lumbar puncture findings make a useful contribution to the patients- management.

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Author: Rachel Kneen - Tom Solomon - Richard Appleton

Source: https://link.springer.com/







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