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ORIGINAL ARTICLE
Year : 2014  |  Volume : 27  |  Issue : 2  |  Page : 230-233

Should a neonate with possible late-onset sepsis always have lumbar puncture?


Department of Pediatrics, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt

Correspondence Address:
Shimaa Abdallah
Neonatal Intensive Care Unit, Benha Children Hospital
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.141649

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Objectives The aim of this work was to study the incidence of neonatal meningitis among newborns with late-onset sepsis, and to determine whether it is mandatory to perform a lumbar puncture and cerebrospinal fluid (CSF) analysis in all cases of late-onset neonatal sepsis. Background Neonatal sepsis is an important cause of neonatal morbidity and mortality and often results in prolonged hospitalization of infants who are admitted to neonatal ICUs. A positive blood culture confirms sepsis, and when the blood culture is negative, the condition is considered as clinical sepsis. It is almost impossible to distinguish sepsis from meningitis in the neonate clinically. However, CSF that is positive for pathogenic bacteria indicates meningitis. Patients and methods This study was carried out in the neonatal ICU in the Benha Children Hospital over 60 neonates presenting with late-onset neonatal septicemia. All studied neonates were subjected to history taking, clinical examination stressing on points of the clinical sepsis score, routine investigations (complete blood count, C-reactive protein, blood culture), and CSF analysis and culture. Results All 60 neonates were positive for the clinical sepsis score: 48 cases were positive for the hematological sepsis score and 12 cases out of 60 were positive for CSF culture; among the 12 cases with positive CSF cultures, there were six cases (50%) with negative blood cultures. Conclusion There is a high incidence of neonatal meningitis among neonates with late-onset sepsis. Neonatal meningitis frequently occurs in the absence of bacteremia. Hence, lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.


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