Discussion of Lumbar Puncture in Infants Aged Less than 3 Months Who Visited Emergency Department
Journal of the Korean Society of Emergency Medicine
; : 643-649, 2017.
Article
em Ko
| WPRIM
| ID: wpr-53382
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE: This study was conducted to confirm the necessity of lumbar puncture to identify the cause of fever in febrile infants aged less than 3 months who visited an emergency department. METHODS: This was a retrospective study conducted on 399 infants aged 31 days to 90 days who visited the emergency department with fever from March 2014 to February 2016. RESULTS: Of the 399 patients, 49 patients had serious bacterial infections (SBI), and were finally diagnosed with urinary tract infection (UTI), sepsis, and bacterial meningitis. Of these, only one case was diagnosed with bacterial meningitis, and this patient was accompanied by sepsis. UTIs were present in 47 patients, and only 1 case was diagnosed with sepsis without bacterial meningitis or UTI. The Boston criteria and Philadelphia criteria included the cerebrospinal fluid (CSF) results for predicting SBI. In this study, the modified Philadelphia criteria was used, which does not include the CSF results, and there was no factor that showed a significant correlation as a result of statistical analysis. Rather, a C-reactive protein ≥50 mg/L, procalcitonin ≥2 ng/mL, and fever over 39℃C showed statistical significance with SBI. In this study, the 1 patient diagnosed with bacterial meningitis also met all three factors (C-reactive protein, 106 mg/L; procalcitonin, 40.25 ng/mL; peak body temperature, >39℃). CONCLUSION: Because the incidence of bacterial meningitis has decreased recently, when an infant under 3 months of age visits the emergency room with fever, lumbar puncture should be performed selectively to identify the cause.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Punção Espinal
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Infecções Bacterianas
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Infecções Urinárias
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Temperatura Corporal
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Proteína C-Reativa
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Líquido Cefalorraquidiano
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Incidência
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Estudos Retrospectivos
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Meningites Bacterianas
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Sepse
Tipo de estudo:
Incidence_studies
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Observational_studies
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Prognostic_studies
Limite:
Humans
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Infant
Idioma:
Ko
Revista:
Journal of the Korean Society of Emergency Medicine
Ano de publicação:
2017
Tipo de documento:
Article