Document Detail

Well appearing young infants with fever without known source in the emergency department: are lumbar punctures always necessary?
MedLine Citation:
PMID:  19820403     Owner:  NLM     Status:  MEDLINE    
We included 685 consecutive previously healthy well appearing infants younger than 3 months with fever without known source admitted to an Emergency Department without routinely performing lumbar punctures (LP). LP was performed in 198 infants. Of these, 36 (18.1%) showed pleocytosis. Two infants less than 15 days were diagnosed with bacterial meningitis and 47 with aseptic meningitis (6.8%). LP was not performed in 487 infants. Of these, 69 were admitted to ward (46 had urinary tract infection) and 418 were discharged. In this group, we registered 38 unscheduled revisits to the Emergency Department (four aseptic meningitis). All infants did well. It is unnecessary to perform a LP routinely on infants over 1 month of age. The decision to perform the LP in previously healthy and well appearing infants with fever without known source attended by an experienced paediatric emergency physician can be individualized with no subsequent adverse outcomes. This approach may lead to under-diagnosing nonbacterial meningitis.
Santiago Mintegi; Javier Benito; Eider Astobiza; Susana Capapé; Borja Gomez; Andere Eguireun
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  17     ISSN:  1473-5695     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  167-9     Citation Subset:  IM    
Department of Paediatric Emergency, Cruces Hospital, Basque Country, Spain.
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MeSH Terms
Emergency Service, Hospital*
Fever of Unknown Origin / diagnosis*,  microbiology
Health Status
Infant, Newborn
Meningitis, Aseptic
Meningitis, Bacterial
Prospective Studies
Spinal Puncture*

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