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KMID : 0385920170280060643
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Journal of the Korean Society of Emergency Medicine
2017 Volume.28 No. 6 p.643 ~ p.649
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Discussion of Lumbar Puncture in Infants Aged Less than 3 Months Who Visited Emergency Department
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Lee Sang-Yeop
Lee Hyun-Jung
Kim Jae-Woo
Moon Hyung-Jun
Lee Dong-Wook
Lee Jung-Won
Choi Jae-Hyung
Park Joon-Soo
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Abstract
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Purpose: This study was conducted to confirm the necessity of lumbar puncture to identify the cause of fever in febrile infants aged less than 3 months who visited an emergency department.
Method: This was a retrospective study conducted on 399 infants aged 31 days to 90 days who visited the emergency department with fever from March 2014 to February 2016.
Results: Of the 399 patients, 49 patients had serious bacterial infections (SBI), and were finally diagnosed with urinary tract infection (UTI), sepsis, and bacterial meningitis. Of these, only one case was diagnosed with bacterial meningitis, and this patient was accompanied by sepsis. UTIs were present in 47 patients, and only 1 case was diagnosed with sepsis without bacterial meningitis or UTI. The Boston criteria and Philadelphia criteria included the cerebrospinal fluid (CSF) results for predicting SBI. In this study, the modified Philadelphia criteria was used, which does not include the CSF results, and there was no factor that showed a significant correlation as a result of statistical analysis. Rather, a C-reactive protein ≥50 mg/L, procalcitonin ≥2 ng/mL, and fever over 39
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KEYWORD
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Meningitis, Bacterial, Fever, Spinal puncture, Infant
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