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

World Journal of Neurology 2023年第4期9卷 37-43页

作者： Arunava Saha Shihla Shireen Kanamgode Sarat Chandra Malempati Sirshendu Chaudhuri Jeffrey Scott Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Assistant Professor Indian Institute of Public HealthHyderabad 500030TelanganaIndia Department of Pulmonary and Critical Care Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United *** 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 *** some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed *** such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive *** 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 *** 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 *** 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 *** patients were subsequently divided into two groups based on whether they received a LP or not,and data was *** A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in 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 *** most commonly identified organism was streptococcus *** 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

关键词： meningitis acute meningitis syndrome Lumbar puncture CSF analysis acute bacterial meningitis Suspected meningitis

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