End-of-treatment spinal tap in bacterial meningitis. Is it worthwhile?

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Abstract
Examination of CSF at the end of treatment for bacterial meningitis is a common clinical practice. Because its value as a test of cure is questionable, 165 cases, in which a posttreatment spinal tap was done were reviewed. Frequency distributions of spinal fluid findings are presented, showing that strikingly wide ranges of glucose and protein levels and cell counts at the end of treatment are compatible with cure. The CSF findings failed to provide a warning in the only 2 patients in whom treatment failure was diagnosed later. In 13 others, the results led to unnecessary intervention. Thus the posttreatment lumbar puncture is usually valueless as a test of cure in bacterial meningitis and can do more harm than good.

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