Febrile Infants Aged 30 to 90 Days with Positive Urinalyses Require Lumbar Puncture

Despite the authors' conclusion that lumbar puncture is not needed, this study failed to show lower risk for meningitis in febrile infants with urinary tract infections.

In a retrospective study of infants aged 30 to 90 days who presented to a tertiary pediatric emergency department with fever ≥38^°C and who received a full septic work-up, researchers assessed the need for lumbar puncture to rule out meningitis in infants with positive urinalysis. Excluded were infants born before 35 weeks' gestation, those with chronic underlying medical conditions, and those who received antibiotics prior to culture. Positive urinalysis was defined as presence of at least one of the following criteria: positive leukocyte esterase, positive nitrites, or >10 white blood cells per high-power field.

Of 392 infants enrolled from 2001 to 2005, 57 had positive urinalyses. Of four infants with culture-proven meningitis, only one (a…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Febrile Infants Aged 30 to 90 Days with Positive Urinalyses Require Lumbar Puncture

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Reviewing Author