Scenario

You are asked to consult on a 3-week-old neonate who was admitted for a ‘full septic screen’. He had a lumbar puncture several hours after starting antibiotics. The lumbar puncture was traumatic and revealed pleocytosis (increased red and white cells). Cultures remained sterile after 72 h, but there was concern that the antibiotics had caused a false negative culture result. You wonder if in this scenario MRI would be useful to aid diagnosis of meningitis.

Structured clinical question

In a 3-week-old neonate with suspected meningitis [patient], does MRI [intervention] assist in the diagnosis of bacterial meningitis [outcome]?

Search strategy and outcome

PubMed was searched using the following keywords: (MRI) AND (diagnosis of) AND (infectious meningitis). This resulted in 260 articles. Seven of these articles were relevant to our question, of which two were review articles. We excluded studies examining tuberculous and/or fungal meningitis only.

The search was repeated independently by a librarian. An additional search via Ovid MEDLINE and Scopus databases did not identify any new papers. Related links and references in the selected articles were reviewed.

Commentary

Lumbar puncture with cerebrospinal fluid (CSF) evaluation …