Lumbar punctures and meningitis
G. W. Fischer, R. W. Brenz, E. R. Alden and J. B. Beckwith
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 culture 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.
