The need to repeat lumbar puncture.
Four patients with bacterial meningitis are reported. On initial examination 1 patient had a slightly abnormal cerebrospinal fluid (CSF), and in the other 3 patients the CSF was completely normal. An obviously purulent CSF was obtained when lumbar puncture was repeated 14-48 hours later. All 4 patients presented initially with pyrexia, and either neck stiffness or convulsions. In 3 of the 4 patients a cause for pyrexia was found on initial examination but lumbar punctures were done for neck stiffness or convulsions to exclude meningitis. The problems and the need to repeat a lumbar puncture, as well as the importance of blood cultures in a patient with suspected meningitis, are discussed. The fact that a normal specimen of CSF does not exclude meningitis is stressed.
D002555:Cerebrospinal Fluid / Q000382:microbiology; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000382:microbiology; D009345:Neisseria meningitidis / Q000302:isolation & purification; D013129:Spinal Puncture