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Although first simple febrile seizure (FSFS) usually is not the sole manifestation of bacterial meningitis, the American Academy of Pediatrics (AAP) practice parameter for the diagnostic evaluation of FSFS in children recommends that lumbar puncture (LP) be “strongly considered” for patients younger than 12 months and “considered” for those aged 12 to 18 months (Pediatrics 1996; 97:769). Investigators challenged this recommendation in the era of Haemophilus influenzae type B and pneumococcal conjugate vaccines.
The investigators retrospectively reviewed charts of well-appearing children aged 6 to 18 months who presented within 12 hours after FSFS to a single emergency department in Boston between 1995 and 2006. The primary outcome was the ra…