Assuntos
Infecções Bacterianas , Empiema/etiologia , Pneumonia/etiologia , Infecções Bacterianas/tratamento farmacológico , Infecções por Bacteroides , Criança , Pré-Escolar , Empiema/microbiologia , Humanos , Masculino , Penicilina G/uso terapêutico , Peptostreptococcus , Pneumonia/tratamento farmacológico , Pneumonia/microbiologiaRESUMO
A hundred clinical records of children between the ages of 6 and 18 months were examined. These previously healthy children, were hospitalized after having their first febrile seizure. Lumbar puncture were performed on 42 of them, showing the existence of meningitis in 4 cases, 2 of which were bacterial meningitis. Previously, clinical criteria for meningitis diagnosis were: alteration of general condition, irritability, vomiting, bulging fontanelle and meningeal signs; in these 4 cases, the clinical criteria were noticed. In 17 puncture patients who did not fulfil clinical criteria, the cerebrospinal fluid was normal. The sensitivity and negative predictive value of these clinical criteria were 100% and their application in this series would have avoided the lumbar puncture in 40% of cases. The utility of peripheral white blood cell counts following TOOD's patterns for the bacterial meningitis diagnosis was low, with a sensibility of 50%. We conclude that the lumbar puncture in these children should not be performed as a routine measure.
