Role of lumbar puncture in clinical outcome of suspected acute bacterial meningitis  

作　　者：Arunava Saha Shihla Shireen Kanamgode Sarat Chandra Malempati Sirshendu Chaudhuri Jeffrey Scott 

机构地区：[1]Department of Internal Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States [2]Assistant Professor,Indian Institute of Public Health,Hyderabad 500030,Telangana,India [3]Department of Pulmonary and Critical Care Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States

出　　处：《World Journal of Neurology》2023年第4期37-43,共7页世界神经病学杂志

摘　　要：BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)studies in patients presenting with acute meningitis syndrome,and beginning treatment with broad spectrum antibiotics based on the age and certain predisposing conditions.In some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed attempt.In such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive diagnosis.AIM To determine whether a diagnostic LP in acute meningitis syndrome was associated with a better outcome and less duration of antibiotic therapy,along with potential causes for deferral of procedure.METHODS A retrospective study was conducted amongst the patients presenting to a 360 bedded community hospital in central Massachusetts with a diagnosis of acute meningitis syndrome between January 2010-September 2022.The electronic health records were accessed to collect necessary demographic and clinical data,including etiology of meningitis,lumbar puncture results,reason for procedure deferral,duration of antibiotic therapy and clinical outcome.The patients were subsequently divided into two groups based on whether they received a LP or not,and data was analyzed.RESULTS A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in the study.The mean age of the participants was 54.3 years(SD+/-19.2 years).LP was performed for 130(76.9%)participants,out of which,28(21.5%)showed some growth in CSF culture.The most commonly identified organism was streptococcus pneumoniae.Amongst the 39 patients in whom LP was deferred,the major reasons recorded were:Body habitus(n=6,15.4%),and unsuccessful attempt(n=4,10.3%).While 93(71.5%)patients with LP received antibiotic therapy,only 19(48.7%)patients withou

关 键 词：MENINGITIS Acute meningitis syndrome Lumbar puncture CSF analysis Acute bacterial meningitis Suspected meningitis 

分 类 号：R51[医药卫生—内科学]