What is the role of lumbar puncture in the workup of Haemophilus influenzae type b (Hib) meningitis?

Updated: Jul 09, 2018
  • Author: Prateek Lohia, MD, MHA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Lumbar puncture is critical in the evaluation of patients with suspected meningitis. Lumbar puncture results may confirm the diagnosis of meningitis or suggest an alternative diagnosis. In cases of bacterial meningitis, CSF Gram stain and culture may identify the organism causing meningitis, which is advantageous in that treatment and prognostication can be adjusted to the specific organism. Identification of increased pressure by lumbar puncture may also modify the therapy provided.

CSF abnormalities are found in approximately 16-20% of children who are evaluated by lumbar puncture for possible meningitis. Of the children with abnormalities, 60-68% have viral infection, 20-26% have bacterial infection, and the cause remains unclear or unknown in 5-10%.


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