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Bulging fontanelle in febrile infants: is lumbar puncture mandatory?
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  • Published on:
    Re: Bulging fontanelle in febrile infants: lumbar puncture is mandatory

    Dear Editor, We thank doctors Beri and Hussain for their comments. They disagree with the suggestion of withholding a lumbar puncture in a specific subset of infants with fever and bulging fontanelle. One of the points they raised is that cases with aseptic meningitis will be missed. However, the purpose of performing a lumbar puncture in infants with fever and bulging fontanelle is not to diagnose aseptic meningitis but...

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    Conflict of Interest:
    None declared.
  • Published on:
    Bulging fontanelle in febrile infants: lumbar puncture is mandatory
    • Sushil Beri, Specialist Registrar, Paediatric Neurology
    • Other Contributors:
      • Dr Nahin Hussain

    We read with interest the study by Shacham et al [1]. Out of 153 children with fever and bulging fontanelle, only one child had bacterial meningitis. However we disagree with their suggestion of withholding lumbar puncture in this group of children. In their cohort, 41 out of 153 children had aseptic meningitis but CSF viral cultures and PCR studies were only done in children who have received antibiotics and had an abn...

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    Conflict of Interest:
    None declared.