RESUMEN
To determine the necessity of lumbar puncture for the cerebrospinal fluid examination in the evaluation of hospitalized elderly patients with confusion and fever. It is a descriptive study conducted in Ahwaz a city southwest Iran, from July 2006 to June 2007. Sixty elderly patients with confusion and fever admitted to a teaching hospital, who had a lumbar puncture and cerebrospinal fluid evaluation to evaluate fever and confusion, were studied. After final diagnosis patients were placed in two groups [meningitis group and bacteremic group] and compared in SPSS using chi square test. Of the total sixty patients, six [10%] were diagnosed as bacterial meningitis. The remaining fifty four [90%] were diagnosed as bacteremia. The primary origins for fever and confusion in bacteremic patients included urinary tract infections [20%], pneumonia [45%], gastroenteritis [17%] and soft tissus infection [8%]. Most hospitalized, elderly patients with fever and confusion have primary causes of the confusion outside the central nervous system and may not require a routine evaluation of their cerebrospinal fluid