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We had a similar case about a month ago.  I am not sure this is terribly
unsusual.  I have seen two other adolescents present with overwhelming
meninigococcal meninigitis (no sepsis - no purpura, petechiae) who went
from being well kids to brain dead within 12-24 hours. Neither had
premortem LPs and both presented to the ED with posturing and herniation.
I think it is unclear of the contribution of the LP to the herniation.
 
Just an opinion.......
 
Steve
 
_____________________
Steve Schexnayder, MD
Arkansas Children's Hospital
University of Arkansas for Medical Sciences
800 Marshall St., Slot 900, Little Rock, AR  72202
Phone (501) 320-1845  Fax: (501)320-3188
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