Utility of Lumber Puncture in theDiagnosis of Bacterial Meningitis among Children with Febrile Seizures and Without ClinicalSigns of Meningitis

Objective: To determine the utility of Lumber Puncture in the diagnosis of bacterial Meningitis among Children with Febrile Seizures and without clinical signs of meningitis Study Design: Cross sectional Study Place and Duration: The study was done in the Children Hospital PIMS Islamabad from February 2009 to August 2009. Materials and Methods: Children between 6 months and 5 years of age who were admitted with seizures associated with fever and without signs of meningitis were included in the study. Lumber puncture (LP) was done by a doctor after written consent from parents. CSF was sent to the pathology laboratory for routine examination, biochemistry and culture. All findings were entered in individual performa. Results: A total of 125 cases were enrolled in the study. Majority of patients 78 (62.4 %) were male. The mean age of patients was 31 months. The results of CSF microscopy showed that 6(4.8%) had abnormal number of leukocyte count, while 119(95.2%) had a normal leukocyte count. Out of 125 study patients ,15(12%) had abnormal level of protein in CSF while 110(88%) had normal level of protein. Similarly 26(20.8%) of the study patients had abnormal glucose level in the CSF while 99 (79.2%) had normal glucose level. In the current study the yield of CSF culture and gram staining was only in 4(3.2%) patients. As per study objectives pyogenic meningitis was diagnosed in 6 patients which was 4.8% of the study patients. Out of these patients 5(4.1%) were up to 1 year of age while 1 (0.8%) was over 1 year of age. Conclusion: A significant number of children presenting with fever and seizures do have meningitis. Children under one year of age constitute a special risk group and in this group LP should be performed in every case of febrile seizures, so that not even a single case of bacterial meningitis can be missed.