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Utility of Lumber Puncture in the Diagnosis of Bacterial Meningitis among Children with Febrile Seizures and Without Clinical Signs of Meningitis

 

Jai Krishin,Maqbool Hussain,Anis ur Rahman,Wajeeha Amber

Ann. Pak. Inst. Med. Sci. 2012; 8(2): 110-112                                            

Objective: To determine the utility of Lumber Puncture in the diagnosis of bacterial Meningitis among Children with Febrile Seizures and without clinical signs of meningitis
Study Design: Cross sectional Study
Place and Duration: The study was done in the Children Hospital PIMS Islamabad from February 2009 to August 2009.
Materials and Methods: Children between 6 months and 5 years of age who were admitted with seizures associated with fever and without signs of meningitis were included in the study. Lumber puncture (LP) was done by a doctor after written consent from parents. CSF was sent to the pathology laboratory for routine examination, biochemistry and culture. All findings were entered in individual performa.
Results: A total of 125 cases were enrolled in the study. Majority of patients 78 (62.4 %) were male. The mean age of patients was 31 months. The results of CSF microscopy showed that 6(4.8%) had abnormal number of leukocyte count, while 119(95.2%) had a normal leukocyte count. Out of 125 study patients ,15(12%) had abnormal level of protein in CSF while 110(88%) had normal level of protein. Similarly 26(20.8%) of the study patients had abnormal glucose level in the CSF while 99 (79.2%) had normal glucose level. In the current study the yield of CSF culture and gram staining was only in 4(3.2%) patients.
As per study objectives pyogenic meningitis was diagnosed in 6 patients which was 4.8% of the study patients. Out of these patients 5(4.1%) were up to 1 year of age while 1 (0.8%) was over 1 year of age.
Conclusion: A significant number of children presenting with fever and seizures do have meningitis. Children under one year of age constitute a special risk group and in this group LP should be performed in every case of febrile seizures, so that not even a single case of bacterial meningitis can be missed.
Keywords: Children, Febrile seizures, Lumber puncture, Meningitis

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