Lumbar Puncture and the Diagnosis of Meningitis

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Abstract
Because the symptomatology of meningitis in infancy frequently is nonspecific, interns and residents staffing a busy pediatric hospital emergency room are encouraged to perform lumbar punctures at the slightest suspicion of meningitis. The effects of this policy were investigated with regard to the number of lumbar punctures done, number of meningitis cases diagnosed, number of meningitis cases missed, and whether the degree of pyrexia and peripheral leukocytosis were helpful diagnostic clues. The results indicate that particularly when inexperienced interns and residents are evaluating young infants in whom the possibility of meningitis is raised, the only definitive diagnostic procedure is lumbar puncture. Hyperpyrexia and/or elevated peripheral white blood cell counts for not helpful in establishing the diagnosis of meningitis. Black infants of low socioeconomic status are a high-risk group for meningitis.

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