• S. Afr. Med. J. · Mar 1977

    Case Reports

    The need to repeat lumbar puncture.

    • E I Soskolne, S H Kuhn, P L Van der Merwe, and M P Keet.
    • S. Afr. Med. J. 1977 Mar 19; 51 (12): 395-6.

    AbstractFour patients with bacterial meningitis are reported. On initial examination 1 patient had a slightly abnormal cerebrospinal fluid (CSF), and in the other 3 patients the CSF was completely normal. An obviously purulent CSF was obtained when lumbar puncture was repeated 14-48 hours later. All 4 patients presented initially with pyrexia, and either neck stiffness or convulsions. In 3 of the 4 patients a cause for pyrexia was found on initial examination but lumbar punctures were done for neck stiffness or convulsions to exclude meningitis. The problems and the need to repeat a lumbar puncture, as well as the importance of blood cultures in a patient with suspected meningitis, are discussed. The fact that a normal specimen of CSF does not exclude meningitis is stressed.

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