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Early lumbar punctu...
Early lumbar puncture in adult bacterial meningitis-rationale for revised guidelines
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Glimaker, M. (författare)
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Johansson, B. (författare)
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- Bell, Max (författare)
- Karolinska Institutet
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- Ericsson, Mats (författare)
- Uppsala universitet,Infektionssjukdomar
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- Bläckberg, Jonas (författare)
- Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Brink, Magnus, 1960 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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- Lindquist, L. (författare)
- Karolinska Institutet
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- Sjölin, Jan (författare)
- Uppsala universitet,Infektionssjukdomar
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(creator_code:org_t)
- 2013-07
- 2013
- Engelska.
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 45:9, s. 657-663
- Relaterad länk:
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http://dx.doi.org/10...
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https://gup.ub.gu.se...
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https://doi.org/10.3...
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https://lup.lub.lu.s...
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http://kipublication...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Current international guidelines recommend cerebral computerized tomography (CT) before lumbar puncture (LP) in many adults with suspected acute bacterial meningitis (ABM), due to concern about LP-induced cerebral herniation. Despite guideline emphasis on early treatment based on symptoms, performing CT prior to LP implies a risk of delayed ABM treatment, which may be associated with a fatal outcome. Firm evidence for LP-induced herniation in adult ABM is absent and brain CT cannot discard herniation. Thus, the recommendation to perform CT before LP may contribute to an avoidable delay of LP and ABM treatment. The inappropriate use of the diagnostic treatment sequence of brain CT scan, followed by LP, followed by antibiotics and corticosteroids should be avoided in adults with suspected ABM by omitting needless contraindications for LP, thus eliminating an unnecessary fear of immediate LP. Revised Swedish guidelines regarding early LP are presented, and the background documentation and reasons for omitting impaired consciousness, new onset seizures, and immunocompromised state as contraindications to LP are discussed.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- Meningitis
- lumbar puncture
- herniation
- antibiotics
- treatment delay
- RAISED INTRACRANIAL-PRESSURE
- PNEUMOCOCCAL MENINGITIS
- COMPUTED-TOMOGRAPHY
- CEREBRAL HERNIATION
- MANAGEMENT
- DIAGNOSIS
- EMERGENCY
- CHILDREN
- CT
- HYPERTENSION
- UBER MG
- 1985
- JOURNAL OF INFECTIOUS DISEASES
- V151
- P528
- LAN DA
- 1989
- ANNALS OF EMERGENCY MEDICINE
- V18
- P856
- Meningitis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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