What is the significance of opening pressure in lumbar puncture for 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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Opening pressure should be recorded. This should be done only when patients are in the lateral recumbent position and are as relaxed and calm as possible.

In bacterial meningitis, opening pressure is frequently elevated, which may have an impact on treatment. In small calm infants, pressures should be less than 160 mm water. Older infants and children should have pressures less than 180 mm water. In some obese individuals, normal pressures are as high as 250 mm water. In fulminant cases of Hib meningitis, pressures as high as 300 mm water to more than 500 mm water may be recorded.

CSF should be collected in a sterile manner in sufficient quantity and immediately submitted to the laboratory. If extra CSF is available, freeze it and store it for possible future evaluation.

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