Confusion and fever in the elderly: the necessity of lumbar puncture for CSF examination

ABSTRACT

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