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Lumbar puncture in late neonatal sepsis

Alonso Zea-Vera, Christie Gloria Turín, María Susana Rueda, Daniel Guillén-Pinto, Pilar Medina-Alva, Aldredo Tori, María Rivas, Jaime Zegarra, Anne Castañeda, Luis Cam, Theresa J Ochoa
The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima. A LP was performed in 45/214 (21.0%) of sepsis evaluations and in 13/48 (27.1%) of culture-proven sepsis. Meningitis was diagnosed in 8/214 (3.7%) of the episodes and 8/45 (17.5%) of the evaluations that included an LP...
June 2016: Revista Peruana de Medicina Experimental y Salud Pública
L Mahieu, J-P Langhendries, V Cossey, C De Praeter, P Lepage, P Melin
Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early-onset sepsis in neonates remains a common source of neonatal morbidity and mortality especially in preterm neonates. The identification of neonates with early-onset sepsis is usually based on perinatal risk factors. Clinical signs are aspecific and laboratory tests are not sensitive. Therefore, many clinicians will overtreat at-risk infants. Inappropriate treatment with antibiotics increases the risk for late-onset sepsis, necrotizing enterocolitis, mortality, and prolongs hospitalisation and costs...
October 2014: Acta Clinica Belgica
Courtney Kiser, Ursula Nawab, Kristin McKenna, Zubair H Aghai
BACKGROUND AND OBJECTIVE: Chorioamnionitis (CAM) is a major risk factor for neonatal sepsis. At our institution, neonates exposed to CAM and intrapartum antibiotics are treated with prolonged antimicrobial therapy if laboratory values are abnormal despite a sterile blood culture. Recently, the Committee on the Fetus and Newborn (COFN) recommended a similar strategy for treating neonates exposed to CAM. Our objective was to determine the frequency of abnormal laboratory parameters in term and late-preterm neonates exposed to CAM and evaluate the implication of recent COFN guidelines...
June 2014: Pediatrics
Varun Kaul, Rekha Harish, Sandesh Ganjoo, Bella Mahajan, Sunil Kumar Raina, Diptiman Koul
OBJECTIVES: The objective of this study was to estimate the prevalence of meningitis in cases with late onset septicemia (LOS). MATERIALS AND METHODS: A prospective study was carried out for a period of 1 year in a tertiary care hospital in North West India to estimate the prevalence of meningitis in cases of LOS. In all the admitted neonates with features of sepsis with a positive C-reactive protein, a lumbar puncture (LP) was carried out and results interpreted on the basis of cerebrospinal fluid (CSF) cytology and biochemistry...
April 2013: Journal of Clinical Neonatology
Nima Alan, Sunil Manjila, Nori Minich, Nancy Bass, Alan R Cohen, Michele Walsh, Shenandoah Robinson
OBJECT: Although survival for extremely low gestational age newborns (ELGANs) has improved in the past 3 decades, these infants remain prone to complications of prematurity, including intraventricular hemorrhage (IVH). The authors reviewed the outcomes for an entire cohort of ELGANs who suffered severe IVH at their institution during the past 12 years to gain a better understanding of the natural history of IVH and frequency of ventriculoperitoneal (VP) shunt placement in this population...
November 2012: Journal of Neurosurgery. Pediatrics
O Flidel-Rimon, E Leibovitz, S Eventov Friedman, A Juster-Reicher, E S Shinwell
No abstract text is available yet for this article.
February 2011: Acta Paediatrica
Annette K Ansong, P Brian Smith, Daniel K Benjamin, Reese H Clark, Jennifer S Li, C Michael Cotten, Barry Mangum, Harmony P Garges, Daniel K Benjamin
OBJECTIVE: Describe cerebrospinal fluid parameters in infants with culture-proven Group B streptococcal meningitis in the era of intrapartum antibiotic prophylaxis. STUDY DESIGN: Cohort study of the first lumbar puncture from 13,495 infants cared for at 150 neonatal intensive care units. We compared cerebrospinal fluid parameters [white blood cell count, red blood cell count, glucose, and protein], demographics, and outcomes between infants with and without Group B streptococcal meningitis...
October 2009: Early Human Development
Barbara J Stoll, Nellie Hansen, Avroy A Fanaroff, Linda L Wright, Waldemar A Carlo, Richard A Ehrenkranz, James A Lemons, Edward F Donovan, Ann R Stark, Jon E Tyson, William Oh, Charles R Bauer, Sheldon B Korones, Seetha Shankaran, Abbot R Laptook, David K Stevenson, Lu-Ann Papile, W Kenneth Poole
CONTEXT: Neonatal meningitis is associated with significant morbidity and mortality. We speculated that meningitis may be underdiagnosed among very low birth weight (VLBW) infants because of the failure to perform lumbar punctures (LPs) in infants with suspected sepsis. OBJECTIVE: This study was undertaken to review the epidemiology of late-onset meningitis in VLBW (401-1500 g) infants and to evaluate the concordance of cerebrospinal fluid (CSF) and blood culture (BC) results...
May 2004: Pediatrics
P McIntyre, D Isaacs
OBJECTIVE: The importance of lumbar puncture (LP) as part of the evaluation of suspected neonatal sepsis is assessed, as it may be the only positive diagnostic test in about 10% of septic babies with meningitis but negative blood cultures. However, LP may compromise respiratory function, and the interpretation of cerebrospinal fluid (CSF) may not be straightforward. CONCLUSION: The clinical setting and the probability of meningitis are important determinants of the likely value of LP...
February 1995: Journal of Paediatrics and Child Health
K D Hendricks-Muñoz, D L Shapiro
Premature infants with respiratory distress commonly receive evaluation for sepsis, including a lumbar puncture, within a short time after admission to a neonatal intensive care unit. We questioned the use of the lumbar puncture during the early sepsis evaluation, and since 1979, have omitted this procedure as part of the initial evaluation for sepsis (within 6 hours of birth) of premature infants. We monitored this policy to detect any change in the incidence of meningitis, and now report results accumulated over a 7-year period...
March 1990: Journal of Perinatology: Official Journal of the California Perinatal Association
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