I would definitely do an LP on the patient that was described. I want
to know if in fact the kid does have viral meningitis - even if I am
certain he does not have bacterial meningitis, he could have a
subarachnoid or other explanation for his fever, lethargy and increasing
headache. I want to have a diagnosis in mind.
If the LP was clearly pointing to viral meningitis as the etiology, I am
comfortable letting him go home with good follow-up. I never keep them
and retap - if I am not sure after the initial LP - I want them admitted
with the antibiotics going.
David F. Soglin, M.D.
Chair, Division of Pediatric Emergency Medicine
Cook County Children's Hospital
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