How Do I Perform a Lumbar Puncture and Analyze the Results to Diagnose Bacterial Meningitis?
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چکیده
A previously healthy 70-year-old woman presents to the emergency department with a 3-day history of fever, confusion, and lethargy. She is unable to cooperate with a full physical examination, but she has neck stiffness upon neck flexion. Her score on the Glasgow Coma Scale is 13 (eye, 4; verbal, 4; motor, 5). The findings from a chest radiograph and urinalysis are normal. You seek consent from her husband to perform a lumbar puncture (LP).
منابع مشابه
Bacterial Infection in Infants and Children with Fever Selected for Lumbar Puncture
ABSTRACT Lumbar puncture (LP) is performed frequently in Pediatric departments to diagnose meningitis in infants and young children with fever. Children selected to have LP who do not have meningitis may, however, have other bacterial infections. During a 2-year desciptive study, we investigated lumbar punctures performed in pediatric departments of Bou-Ali, Emam-Hossein and Loghmane-Hakim ho...
متن کاملبررسی ضرورت پونکسیون مایع نخاع در کودکان مبتلا به اولین حمله تشنج و تب
Background: It is frequently thought that lumbar puncture (LP), is a mandatory procedure in all children presenting with febrile convulsion since convulsion may be the sole clinical manifestation of bacterial meningitis. The present study was conducted to assess whether meningitis could be recognized using readily available clinical information. Materials and methods: During the study period, ...
متن کاملبررسی صحت علایم بالینی در تشخیص ضایعات کنترااندیکه پونکسیون لومبر در بیماران مشکوک به مننژیت حاد
Background: The diagnosis of acute bacterial meningitis rests on CSF examination by lumbar puncture. Before lumbar puncture, intracranial mass lesions that increase intracranial pressure, must be ruled out, so brain CT-scan may be considered . In this study we evaluated the accuracy of physical examination for intracranial mass in patients with meningismus. Materials and Methods: 100 patients ...
متن کاملEvidence-based emergency medicine/rational clinical examination abstract. How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis?
CONTEXT Diagnostic lumbar punctures (LPs), commonly used to rule out meningitis, are associated with adverse events. OBJECTIVE To systematically review the evidence about diagnostic LP techniques that may decrease the risk of adverse events and the evidence about test accuracy of cerebrospinal fluid (CSF) analysis in adult patients with suspected bacterial meningitis. DATA SOURCES We search...
متن کاملCerebral herniation during bacterial meningitis in children.
OBJECTIVE To see whether the incidence of cerebral herniation is increased immediately after lumbar puncture in children with bacterial meningitis and whether any children with herniation have normal results on cranial computed tomography. DESIGN Retrospective review of case notes; computed tomograms were read again. SETTING Large paediatric teaching hospital. SUBJECTS 445 children over 3...
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