Importance of obtaining lumbar puncture in neonates with late onset septicemia a hospital based observational study from north-west India.

OBJECTIVES: The objective of this study was to estimate the prevalence of meningitis in cases with late onset septicemia (LOS).

MATERIALS AND METHODS: A prospective study was carried out for a period of 1 year in a tertiary care hospital in North West India to estimate the prevalence of meningitis in cases of LOS. In all the admitted neonates with features of sepsis with a positive C-reactive protein, a lumbar puncture (LP) was carried out and results interpreted on the basis of cerebrospinal fluid (CSF) cytology and biochemistry. Simultaneous blood and CSF cultures were also taken. All other baseline investigations were performed and in those diagnosed as meningitis an ultrasound head was carried out prior to discharge. No urine cultures were obtained.

RESULTS: The study showed the prevalence of meningitis as 22.5% in neonates with LOS with statistically significant implications of meningitis versus gestation, sex, acquired the place of infection, and outcome in terms of sequelae/mortality.

CONCLUSIONS: Meningitis is commonly associated with late onset sepsis hence LP should be the standard of care in such neonates as the treatment protocol and the outcome is directly proportional to the diagnosis at initial presentation.