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We recommend lumbar puncure for children younger than 1 year with bacteremia,children with Haemophilus influenzae type B cellulitis,and children with fever and seizures not classified as simple.Pretreatment with antibiotics rarely changes cerebrospinal fluid characteristics such that a diagnosis of bacterial meningitis would be obscured.In a traumatic spinal tap,the equation to predict cerebrospinal fluid pleocytosis based on the peripheral blood cell count is invalid.When used together, cerebrospinal fluid glucose level,Gram's staining,and observed-to-expected ratio of white blood cells are highly reliable in diagnosing bacterial meningitis. |
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review article
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