RT Book, Section
A1 Gomella, Tricia Lacy
A1 Cunningham, M. Douglas
A1 Eyal, Fabien G.
A1 Tuttle, Deborah J.
SR Print(0)
ID 1107527485
T1 Lumbar Puncture (Spinal Tap)
T2 Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 7e
YR 2013
FD 2013
PB McGraw-Hill Education
PP New York, NY
SN 9780071768016
LK accesspediatrics.mhmedical.com/content.aspx?aid=1107527485
RD 2024/04/23
AB Obtaining  cerebrospinal  fluid  (CSF)  for  the  diagnosis  of  central  nervous  system  (CNS)  disorders  such  as  meningitis/encephalitis.  Infections  that  can  be  diagnosed  are  bacterial,  viral,  fungal,  and  TORCH  (toxoplasmosis,  other  [usually  syphilis],  rubella,  cytomegalovirus,  and  herpes  simplex  virus).  Meningitis  can  be  present  in  as  many  as  15–25%  of  cases  of  neonatal  sepsis.Aid  in  the  diagnosis  of  intracranial  hemorrhage.  CSF  studies  are  indicative  but  not  diagnostic  for  intracranial  hemorrhage:  large  number  of  red  blood  cells  (RBCs),  xanthochromia,  increased  protein  content,  and  hypoglycorrhachia  (abnormally  low  CSF  glucose  content).Diagnose  an  inborn  error  of  metabolism.  CSF  amino  acid  analysis  can  be  obtained  to  rule  out  nonketotic  hyperglycinemia.  Postmortem  CSF  (1-  to  2-mL  specimen,  frozen)  is  recommended:  suspected  inborn  error  of  metabolism.Draining  CSF  in  communicating  hydrocephalus  associated  with  intraventricular  hemorrhage.  (Serial  lumbar  punctures  for  this  are  controversial.)  Cochrane  review  states  that  early  repeated  CSF  tapping  cannot  be  recommended  for  neonates  at  risk  of  developing  posthemorrhagic  hydrocephalus.Administration  of  intrathecal  medications.  Chemotherapy,  antibiotics,  or  anesthetic  agents  or  contrast  material.Monitoring  efficacy  of  antibiotics  used  to  treat  CNS  infections  by  examining  CSF  fluid.Diagnose  CNS  involvement  with  leukemia.For  the  initial  sepsis  workup  (controversial).  If  CNS  involvement  is  suspected  or  blood  cultures  are  positive,  some  recommend  a  lumbar  puncture  (LP).  Because  signs  and  symptoms  of  neonatal  meningitis  are  so  vague  and  unspecific,  some  clinicians  advise  that  all  infants  with  proven  or  suspected  sepsis  undergo  LP.