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Lumbar punctures and meningitis.

G W Fischer, R W Brenz, E R Alden

    American Journal of Diseases of Children (1960)
    |May 1, 1975
    PubMed
    Summary
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    Meningitis can occur after lumbar puncture (LP) even with normal cerebrospinal fluid (CSF). Consider repeat CSF tests and blood cultures, especially in infants, if meningitis is suspected.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Pediatrics

    Background:

    • Meningitis following lumbar puncture (LP) is a rare but serious complication.
    • Normal cerebrospinal fluid (CSF) findings on initial LP do not always rule out meningitis.

    Purpose of the Study:

    • To highlight the risk of meningitis after LP with normal CSF.
    • To recommend diagnostic and management strategies for suspected post-LP meningitis.

    Main Methods:

    • Review of four patient cases with meningitis post-LP and normal CSF.
    • Inclusion of seven additional cases from existing literature.
    • Reference to animal studies on meningeal perforation and bacteremia.

    Main Results:

    • Meningitis occurred in patients despite initial normal CSF analysis after LP.

    Related Experiment Videos

  • Animal models show that meningeal perforation during bacteremia increases meningitis risk.

    • Conclusions:

    • Obtain simultaneous blood cultures with all LPs.
    • Repeat CSF examination is crucial for deteriorating patients, irrespective of initial LP results.
    • Consider a second LP for newborns and young infants with positive blood cultures.