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4 - Lumbar Puncture

from SECTION I - NEUROLOGICAL EXAMINATION AND NEURODIAGNOSTIC TESTING

Published online by Cambridge University Press:  06 August 2009

James Valeriano
Affiliation:
Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania
Daniel Ammons
Affiliation:
Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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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.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 35 - 42
Publisher: Cambridge University Press
Print publication year: 2003

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References

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  • Lumbar Puncture
    • 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
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.005
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Lumbar Puncture
    • 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
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.005
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Lumbar Puncture
    • 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
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.005
Available formats
×