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Lumbar puncture and urinary tract infection in infants

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You are faced with a febrile, unwell infant (greater than 29 days and younger than 60 days), and you have identified good evidence that they have a urinary tract infection based urinalysis and microscopy of a supra-pubic sample of urine. Should you complete the infection screen with a lumbar puncture (LP) to rule out a co-existing bacterial meningitis? If they are unwell, most clinicians will complete with LP before starting antibiotics. What about well looking infants with fever and evidence of a urinary tract infection, should they have an LP to rule out meningitis? Burstein B et al [JAMA Netw …

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