title: [Indications and diagnosis efficiency of lumbar puncture in emergencies].
abstract: BACKGROUND
  To know the frequency, indications and diagnosis efficiency of lumbar puncture (LP) in the Emergency Department (ED) when suspecting a central nervous system (CNS) infection.
  
  
  METHODS
  We analyzed all the LP performed over a 2-year period in the ED. We compared the clinical characteristics of patients with and without CNS infection. We also reviewed all the cases of CNS infection diagnosed in the hospital in the same period.
  
  
  RESULTS
  A LP was performed in 0.4% of emergencies. In 76% of cases, it was performed because of CNS infection suspicion, which was confirmed in 30% of cases. Fever, headache, nuchal rigidity and chronical otitis were all clinical variables associated with CNS infection. An 80% of CNS infections that were not diagnosed in the ED corresponded to HIV-infected patients.
  
  
  CONCLUSIONS
  Lumbar puncture is frequently performed in the ED, mostly for suspicion of CNS infection, which is eventually confirmed in one third of cases. CNS infection cases which have not been suspected in the ED usually correspond to a subacute meningitis in a HIV-infected patient.
authors.affiliation: Unidad de Urgencias, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Mòdol
authors.forename: Pere
authors.initials: P
authors.lastname: Tudela
authors.forename: Aina
authors.initials: A
authors.lastname: Veny
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Sahuquillo
authors.forename: Jordi
authors.initials: J
authors.lastname: Tor
authors.forename: Montserrat
authors.initials: M
authors.lastname: Giménez
mesh_terms: D002494:Central Nervous System Infections / Q000175:diagnosis*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013129:Spinal Puncture / Q000592:standards*