Exclude contraindications to lumbar puncture Aid in diagnosis of meningitis or identification of other causative pathologies Evaluate for conditions predisposing to meningitis (skull fracture, sinus or mastoid infection, congenital anomalies) Identify and monitor...
CT imaging is important when raised ICP suspected: Lumbar puncture may precipitate cerebral herniation Should be performed if in all patients presenting with: Focal neurologic deficits (excluding cranial nerve palsies) New-onset seizures Severely altered mental status...
Normal Bacterial Meningitis Opening Pressure 5-20 >30 Appearance Normal Turbid Cell Differential Normal Neutrophilic (polymorphonuclear) pleocytosis WCC (per mm3) <3 >500(Up to 100,000) Protein (g/L) 0.2-0.4 >1High Glucose-Serum Ratio 0.5-0.66(2.5-3.5...
Intensive care teams should be involved early in patients, given the high mortality rate and predisposition to rapid deterioration Suggested criteria for intensive care admission include: Rapidly evolving rash GCS <12 or less or a drop of >2 points (Intubation...