Viral meningitis lumbar puncture: Difference between revisions
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==Overview== | ==Overview== | ||
Lumbar puncture is the most important specific diagnostic procedure for detecting viral meningitis and to exclude other causes of meningitis. It is indicated for all suspected patients of viral meningitis. The CSF findings in case of viral meningitis include high glucose concentration, normal or slightly high protein, increased number of lymphocytes and lactates level of <2.1 mmol/l.<ref name="pmid23639837">{{cite journal| author=Casasoprana A, Hachon Le Camus C, Claudet I, Grouteau E, Chaix Y, Cances C et al.| title=[Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases]. | journal=Arch Pediatr | year= 2013 | volume= 20 | issue= 6 | pages= 594-600 | pmid=23639837 | doi=10.1016/j.arcped.2013.03.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23639837 }} </ref><ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948 }} </ref> | Lumbar puncture is the most important specific diagnostic procedure for detecting viral meningitis and to exclude other causes of meningitis. It is indicated for all suspected patients of viral meningitis. The CSF findings in case of viral meningitis include high glucose concentration, normal or slightly high protein, increased number of lymphocytes and lactates level of <2.1 mmol/l. CT scan should be done before lumbar puncture procedure in the immune deficient patient or patients with increased intracranial pressure.<ref name="pmid23639837">{{cite journal| author=Casasoprana A, Hachon Le Camus C, Claudet I, Grouteau E, Chaix Y, Cances C et al.| title=[Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases]. | journal=Arch Pediatr | year= 2013 | volume= 20 | issue= 6 | pages= 594-600 | pmid=23639837 | doi=10.1016/j.arcped.2013.03.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23639837 }} </ref><ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948 }} </ref> | ||
==Lumbar puncture== | ==Lumbar puncture== | ||
Latest revision as of 13:15, 21 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Lumbar puncture is the most important specific diagnostic procedure for detecting viral meningitis and to exclude other causes of meningitis. It is indicated for all suspected patients of viral meningitis. The CSF findings in case of viral meningitis include high glucose concentration, normal or slightly high protein, increased number of lymphocytes and lactates level of <2.1 mmol/l. CT scan should be done before lumbar puncture procedure in the immune deficient patient or patients with increased intracranial pressure.[1][2]
Lumbar puncture
Indicaitons of lumbar puncture
Lumbar puncture is indicated in all pateints with strong suspicion of meningitis for the following reasons:[3]
- To confirm the diagnosis
- To differentiate the different causes of meningitis
- To diagnose the specific causative agent for bacterial meningitis
- To start the appropriate treatment as early as possible to prevent complications
Findings of lumbar puncture in viral meningitis
- High count of white blood cells (10-100 cells/µL)
- High glucose ratio (CSF/plasma) >0.6
- Normal protein level but may be slightly elevated
- Increased number of the lymphocytes > granulocytes
- Lactate levels <2.1
Contraindications of lumbar puncture
Contraindications of lumbar puncture include the following:[3]
- Increased intracranial pressure
- Mass lesion such as tumour
- Thrombocytopenia
- Bleeding diathesis
References
- ↑ Casasoprana A, Hachon Le Camus C, Claudet I, Grouteau E, Chaix Y, Cances C; et al. (2013). "[Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases]". Arch Pediatr. 20 (6): 594–600. doi:10.1016/j.arcped.2013.03.022. PMID 23639837.
- ↑ Negrini B, Kelleher KJ, Wald ER (2000). "Cerebrospinal fluid findings in aseptic versus bacterial meningitis". Pediatrics. 105 (2): 316–9. PMID 10654948.
- ↑ 3.0 3.1 Doherty CM, Forbes RB (2014). "Diagnostic Lumbar Puncture". Ulster Med J. 83 (2): 93–102. PMC 4113153. PMID 25075138.