Díaz A Manuel, Viel R Yamilka, Acosta B Bárbara, Claver I Daniel
Servicio de Neonatología, Hospital Pediátrico Universitario Juan M. Márquez, Ciudad de la Habana, Cuba.
Rev Chilena Infectol. 2008 Jun;25(3):179-83. Epub 2008 Jun 24.
Lumbar puncture to detect bacterial meningitis is a recommended screening procedure to be performed in febrile newborn infants at admission to hospital.
To evaluate the usefulness of this procedure performed at admission and eventually, in a second look if clinically justified.
There were studied 1,841 febrile newborns consulting at the Emergency Department from January 1992 to December 2000 without source. All of them underwent a sepsis workup. The rate of meningitis incidence was calculated, and we analyzed the frequency of meningitis diagnosed in the initial evaluation and reappraisal.
There were 206 febrile patients with diagnosis of meningitis for an incidence of 11.2%, which 20 were bacterial (1.1%) and 186 aseptic meningitis (10.1%). In the initial evaluation 155 patients were diagnosed with meningitis (155/ 1.774 = 8.7%) and in reappraisal (mean 39,5 +/- 25,2 hours after) there were diagnosed another 51 cases (51/ 135 = 37.8%).
The meningitis was a common diagnosis in febrile newborns without source, with prevalence of aseptic meningitis. In almost 25% of cases we reached to this diagnosis by means of performing lumbar puncture after a reappraisal.
腰椎穿刺检测细菌性脑膜炎是推荐用于发热新生儿入院时的筛查程序。
评估入院时进行该程序的有效性，最终在临床合理时进行复查。
研究了1992年1月至2000年12月在急诊科就诊的1841例无明确病因的发热新生儿。所有患儿均接受了败血症检查。计算脑膜炎发病率，并分析初始评估和复查中诊断出的脑膜炎频率。
206例发热患者诊断为脑膜炎，发病率为11.2%，其中20例为细菌性脑膜炎（1.1%），186例为无菌性脑膜炎（10.1%）。初始评估中155例患者诊断为脑膜炎（155/1774 = 8.7%），复查时（平均在39.5±25.2小时后）又诊断出51例（51/135 = 37.8%）。
脑膜炎是无明确病因发热新生儿的常见诊断，无菌性脑膜炎占多数。近25%的病例通过复查时进行腰椎穿刺得以确诊。
