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Yield of lumbar puncture among children who present with their first complex febrile seizure

Amir Kimia1, Elana Pearl Ben-Joseph, Tiffany Rudloe

  • 1Division of Emergency Medicine, Department of Medicine, Children's Hospital Boston, Boston, MA 02115, USA. amir.kimia@childrens.harvard.edu

Pediatrics
|June 23, 2010
PubMed

Insights

Acute bacterial meningitis (ABM) is rare in children experiencing their first complex febrile seizure (CFS) without other concerning symptoms. Lumbar puncture is crucial for diagnosis in these pediatric cases.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Febrile seizures are common in children.
  • Complex febrile seizures (CFS) warrant thorough evaluation to rule out serious underlying conditions.
  • Acute bacterial meningitis (ABM) is a critical diagnosis to exclude in children with seizures.

Purpose of the Study:

  • To determine the incidence of acute bacterial meningitis (ABM) in children presenting with their first complex febrile seizure (CFS).

Main Methods:

  • Retrospective cohort review of 526 children aged 6-60 months with their first CFS.
  • Data collected included seizure characteristics, physical exam findings, and laboratory results.
  • Lumbar puncture (LP) was performed in 64% of patients.

Main Results:

  • Three out of 526 patients (0.9%) were diagnosed with ABM.
  • Two ABM cases were associated with Streptococcus pneumoniae.
  • Patients with ABM often presented with additional concerning signs like unresponsiveness or bulging fontanel.

Conclusions:

  • The rate of ABM is low in children with a first complex febrile seizure, especially when other signs or symptoms are absent.
  • Clinical presentation is key in identifying children at risk for ABM.
  • Further investigation, including LP, is vital for definitive diagnosis.
Abstract

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