When are cultures most useful for diagnosing meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Obtaining cultures before instituting antibiotics may be helpful if the diagnosis is uncertain. The utility of cultures is most evident when LP is delayed until head imaging can rule out the risk of brain herniation, in which cases adjunctive dexamethasone and antimicrobial therapy is rightfully initiated before CSF samples can be obtained. These cultures include the following:

  • Blood - 50% positive in meningitis caused by H influenzae, S pneumoniae, or N meningitidis
  • Nasopharynx
  • Respiratory secretions
  • Urine
  • Skin lesions

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