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A lumbar puncture diagnoses or excludes meningitis.
It has been suggested that 1 of 3 findings (fever, neck stiffness, altered mental state) is present in virtually all patients with meningitis and that the absence of these features virtually excludes meningitis with a high negative predictive value (table 1) [ 1].
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No single cerebrospinal fluid (CSF) value can be used to exclude meningitis, and peripheral WBC counts are poor predictors of neonatal meningitis [ 8].
Of the total hospitalisations for patients with PHN, 92.6% were related to cranial and peripheral nerve disorders and infections of the nervous system (excluding meningitis).
S. aureus was the most frequently isolated pathogen amongst Gambian neonates (less than three months old) with serious infections excluding meningitis [ 34].
Of the total hospitalisations for HZ, 92.3% were related to major skin disorders, eye disorders, infections of the nervous system (excluding meningitis) and viral illnesses.
We analyzed clinical and laboratory data from a series of 1146 patients to identify findings that could exclude bacterial meningitis.
However, we reliably excluded bacterial meningitis in these children as all had a CSF bacterial culture with no antibiotic pretreatment within 72 h of diagnostic LP.
Fingerstick CRAG had 100% negative predictive value for excluding cryptococcal meningitis.
Lumbar punctures were performed according to a standard protocol to exclude pyogenic meningitis[ 24].
Lumbar puncture findings contributed to the management in 18 (72%) of these patients, by identifying a causative organism or excluding bacterial meningitis.
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