Abstract
Background: Acute bacterial meningitis (ABM) is a potentially fatal illness. In spite of modern therapy and intensive care, the death rate remains between ten percent and thirty percent, and the possibility of persistent neurological or auditory deficits is high.
Aim: To evaluate the outcome of lumbar puncture (LP) carried out rapidly or following neuroimaging in acute bacterial meningitis in adults
Patients and methods: This prospective investigation has been performed on 600 adult cases with acute bacterial meningitis (ABM) with age >16 years. The diagnoses of ABM have been dependent on cerebrospinal fluid analysis, clinical criteria, and blood microbiological tests. This study was done at Al-Azhar University from May 2020 to Jan 2021.
Results: A statistically insignificant distinction has been observed among lumbar puncture without before CT and lumbar puncture following CT regarding age, sex, immunocompromised state, and reaction level scale (RLS) 2–3 mental status, while there was a statistically significant lower in LP after CT when compared to LP without prior CT regarding Neisseria meningitides, RLS 1 mental status, and time from admission to appropriate therapy and a significant increase regarding Streptococcus pneumoniae and RLS 4–8 mental status.
Conclusion: CT-conducted prior lumbar puncture slows and elevates the death possibility. In instances of mass lesions or impending herniation, a CT scan must be conducted. A prompt lumbar puncture is recommended, and altered mental status, seizures, and immunocompromised states shouldn't be considered for neuroimaging in cases with suspected ABM