Indication for lumbar puncture in child with febrile seizures are all except?
- All the above given choices are indication for lumbar puncture but the least useful indication is option D i.e. infants pretreated with antibiotics. - As the baby is already treated with antibiotics, the lumbar puncture wouldn't give a true picture that whether the baby actually had CNS infection or not, the condition might be altered and be normalized with antibiotics. - Since we already staed antibiotics, it might not help much although it might help decide duration of antibiotics. But compared to above other 3 situations, lumbar puncture here is least useful. LUMBAR PUNCTURE IN FEBRILE SEIZURES: Meningitis should be considered in the differential diagnosis, and lumbar puncture should be performed for: All infants <6m of age who presents with fever and seizure, or If the child is ill-appearing or at any age if there are clinical signs or symptoms of concern. A lumbar puncture is an option in a child 6-12m of age who is deficient in H. influenzae type b and streptococcus pneumoniae immunizations or for whom immunization status is unknown.
All infants <6 months
Children 6 to 12 months with no Hib & pneumococcal vaccination
Severely ill infants with clinical signs and symptoms
Infants pretreated with antibiotics
Febrile seizures