Diagnostic value of lumbar puncture among infants and children presenting with fever and convulsions.
BACKGROUND
Central nervous system (CNS) infections can be categorized according to the nature of the infectious pathogen into viral, bacterial, protozoan, or fungal. The diagnosis of diffuse CNS infections depends on examination of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP). The aim of this work was to determine the diagnostic value of CSF analysis in infants and children presenting with fever and convulsions.


METHODS
Detailed clinical data of infants and children included in this study were collected with special reference to the course and duration of the illness, description of the convulsions, consciousness level, signs of increased intracranial pressure, and signs of meningeal irritation. Lumbar puncture and chemical and bacteriological analyses of the obtained cerebrospinal fluid were done for all of the children.


RESULTS
The total number of children included in the study was 85, they had a median age 19 months, and 88% of them had generalized convulsions. CSF examination revealed that 20% had abnormal physical findings, while 23.5% had abnormal white blood cell count (WBC) (CSF Pleocytosis). CSF cultures were done in three cases with the highest White blood cells (WBCs), and streptococcus pneumoniae was present in all three cases.


CONCLUSIONS
This study found that CNS infections are not uncommon in infants and children presenting with fever and convulsions in our locality, and acute bacterial meningitis cannot be excluded. However, its presence in the absence of clinical symptoms and signs of meningeal irritation is a remote possibility, but it should always be considered.
Assistant Professor and Head of Pediatric Neurology Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Abdelrahim Abdrabou
AA
Sadek
Lecturer, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Mostafa Ashry
MA
Mohamad
Assistant Professor, Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Safaa Hussin
SH
Ali
Assistant Professor, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Ismail Abd Al-Aleem
IA
Hassan
Assistant Lecturer, Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt.
Mohammad Fouad
MF
Hussein
cerebrospinal fluid; encephalitis; lumbar puncture; meningitis