title: [Is lumbar puncture in bacterial meningitis necessary?].
abstract: 3 children with the clinical picture of bacterial meningitis are described. Lumbar puncture was not done on admission due to increased intracranial pressure, cardiopulmonary shock, or petechial rash with suspected coagulopathy. Prompt treatment with broad spectrum antibiotics resulted in successful outcomes. The diagnosis of meningitis can usually be made clinically and the bacteriological diagnosis from blood cultures. We maintain that in fulminating cases lumbar puncture might prove fatal, and should therefore be deferred until the child's condition improves. However, if bacterial meningitis is suspected and lumbar puncture is delayed, intravenous antibiotics should be given immediately after blood is drawn for culture.
authors.affiliation: Pediatric Intensive Care Unit, Chaim Sheba Medical Center, Tel Hashomer.
authors.forename: O
authors.initials: O
authors.lastname: Pinhas-Hamiel
authors.forename: G
authors.initials: G
authors.lastname: Paret
authors.forename: Z
authors.initials: Z
authors.lastname: Barzilay
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001769:Blood / Q000382:microbiology; D001800:Blood Specimen Collection; D002648:Child; D006801:Humans; D007262:Infusions, Intravenous; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D013129:Spinal Puncture / Q000009:adverse effects / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents