Lumbar puncture in neonates under and over 72 hours of age

ABSTRACT

To identify the criteria for performing a spinal tap in neonates with suspected sepsis and compare the findings in infants under and over the age of 72 hours. Analytical. Neonatal Ward of Taleghani Medical Centre, Shaheed Beheshti University of Medical Sciences, Evin,Tehran. Study period was of one year, from March 2003 to February 2004. All newborns subjected to a lumbar puncture during the first 24 hours of admission were enrolled in the study. Results of cerebrospinal fluid analysis were scrutinized. There were 380 neonates in the study. Majority i.e. 248 infants were aged < 72 hours. Meningitis was diagnosed in 22 cases, [5.8%]. There was no significant difference in the incidence of meningitis between neonates under and over 72 hours of age, [6.9% vs. 3.8%, p-value >0.5]. Comparison of risk factors, clinical manifestations, and routine laboratory investigations revealed no significant difference in babies with or without meningitis. The findings of this series do not support a selective approach for performing a lumbar puncture in a possibly septic newborn. A lumbar puncture is recommended in all neonates with suspected sepsis regardless of age, risk factors, or specific neurological manifestations