Bacterial cause of suspected meningitis cannot be safely excluded without cerebrospinal fluid analysis

摘要

Patients with viral meningitis receive no benefit from lumbar puncture, but must bear the risk, medical costs, and adverse side effects of the procedure. Despite these concerns, lumbar puncture has been advocated as a routine procedure for patients with suspected viral meningitis because it provides a reliable means of identifying rare patients who actually have bacterial meningitis. In this edition of Clinical Controversies, physicians with dual training and expertise in emergency medicine and infectious diseases provide contrasting views on the need for lumbar puncture in patients with suspected viral meningitis.