What is the role of lumbar puncture (LP) in the emergent management of pediatric patients with fever?

Updated: Sep 01, 2021
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Diagnostic LP is suggested for ill-appearing febrile infants and children associated with any of the following:

  • Age younger than 8 weeks

  • Complex febrile seizure (< 12 mo)

  • Full anterior fontanelle

  • Persistent vomiting

  • Persistent irritability, lethargy, inconsolability

  • Petechial rash

In young children, the classic signs of meningismus, such as the Kernig or Brudzinski signs, may be absent, even in the presence of CNS infection. See Pediatric Bacterial Meningitis.

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