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Then another doctor explained that they would do a lumbar puncture.
He didn't respond to the antibiotics, so they did a lumbar puncture and diagnosed pneumococcal meningitis.
Five of these children underwent a second lumbar puncture which was negative bacteriologically.
Two had a negative lumbar puncture and all three were treated with penicillin.
If diagnostic uncertainty remains, may need to perform lumbar puncture (to help exclude encephalitis or meningitis).
Lumbar puncture may be impossible in an agitated or confused elderly patient.
If lumbar puncture is refused or impractical, then the patient should be considered for empirical treatment.
If there has been no previous therapy, further investigation by lumbar puncture should be considered, or empirical treatment for neurosyphilis offered.
Results of a lumbar puncture test were negative.
Strategy 1 in the figure presents the results when every child with meningeal signs undergoes a lumbar puncture and empirical treatment until bacterial cultures are conclusive.