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MAJ Gerald W. Fischer, MC, USA; MAJ Ronald W. Brenz, MC, USA; LTC Errol R. Alden, MC, USA; J. Bruce Beckwith, MD

Am J Dis Child. 1975;129(5):590-592.

Abstract
Four patients, with an additional seven from the literature, had meningitis following a lumbar puncture (LP) that disclosed normal cerebrospinal fluid (CSF). Animal studies demonstrate that perforation of the meninges in the presence of bacteremia enhances the development of meningitis. Simultaneous blood cultures should be obtained with all LPs. Regardless of the results of the initial LP, a second CSF examination is recommended in any patient whose clinical condition is deteriorating. If the initial blood culture is positive, a second LP should be strongly considered in all newborn and very young infants.

Author Affiliations
From the Department of Pediatrics, Madigan Army Medical Center, Tacoma, Wash (Drs. Fischer, Brenz, and Alden); and Children's Orthopedic Hospital and Medical Center, Seattle (Dr. Beckwith). Dr. Fischer is now with Tripler Army Medical Center, Honolulu.

Footnotes
Received for publication May 21, 1974; accepted Sept 16.

Reprint requests to Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI 96819 (Dr. Fischer).

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