The Role of Lumbar Puncture in Children Less Than Five Years Who Presented with Fever and Fit a Hospital Based Study


ABSTRACT:BACKGROUND: Lumbar puncture is a procedure that is commonly performed to diagnose meningitis, encephalitis, and subarachnoid hemorrhage and it is helpful in evaluating demyelinating, degenerative and collagen vascular diseases and the presence of tumour cells within the subarachnoid space. It is the test of choice to diagnose pseudo tumor cerebri. OBJECTIVE: To highlight the important role of lumbar puncture in excluding serious central nervous system infections in patients presented with fever and fit. PATIENTS AND METHODS: A prospective study was carried out on 67 patients who were less than five years of age, presented with fever and fit from the 1st of April 2011till thirty first of October 2011, who were admitted to the Children Welfare Teaching Hospital/ medical city / Baghdad for evaluation and management. All the patients underwent lumbar puncture. RESULTS : There were 67 patients with male predominant (52%) , the common age of presentation was between one month to one year ; 42 (62%) , 38 (56%) of patients presented with high grade fever and fit , 42 (62%) patients presented with simple fit , 25 (38%) presented with complex fit , 40 (59%) presented with generalized fit , 27 ( 41%) presented with focal fit , 28 ( 42%) patients presented as first attack and 39 (58%) presented as a recurrent attack ,in 11 (17%) the result of gram stain was positive while 56 (83%) the results were negative , 9 (14%) the results of cerebral spinal fluid culture showed growth of bacteria while 58 (86%) showed no growth.CONCLUSION: The lumbar puncture is necessary in patients presented with fever and fit especially in infancy and those presented with high grade fever and recurrent and complex fit to exclude central nervous system infection..