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4 - Lumbar Puncture
- from SECTION I - NEUROLOGICAL EXAMINATION AND NEURODIAGNOSTIC TESTING
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- By James Valeriano, Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania, Daniel Ammons, Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
- Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
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- Book:
- Principles and Practice of Emergency Neurology
- Published online:
- 06 August 2009
- Print publication:
- 18 February 2003, pp 35-42
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Summary
The only absolute contraindication to performance of a lumbar puncture (LP) is the presence of infection over the puncture site. Potential side effects of lumbar puncture range from minor to life threatening. Even in the absence of infection in the region of the puncture site, there is a risk of introducing an infection into the spinal canal. Strict sterile precautions must therefore be maintained to minimize this risk. Meningitis can develop following LP in a bacteremic patient. D. W. Teele reported that 7 of 46 bacteremic patients developed meningitis following an (initially negative) diagnostic LP. In a patient with equivocal test results and a negative Gram stain, empiric antibiotics therapy is begun until culture results are available. In cases where the examiner has a high pretest probability of bacterial meningitis, the patient should receive appropriate antibiotics before or immediately after LP is performed, without waiting for results to become available.
Looking Backward, Looking Forward: MLA Members Speak
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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