Initial clinical assessment of the comatose patient

Routine lumbar puncture in children with febrile seizures in Ghana: should it continue?

“…The initial evaluation of such patients presenting in a coma to hospitals in developing countries has traditionally included an LP. 8 Ideally each febrile child who convulses must be assessed on an individual basis by combining history Routine lumbar puncture in children with febrile seizures in Ghana and physical examination findings and then determining whether an LP is warranted. Duration of fever prior to hospitalization has been reported to be a useful clinical clue in diagnosis.…”

“…Also, in developing countries, most children are brought to the hospital when the child's disease is in an advanced state, resulting in most deaths occurring a few hours after admission. 8 For cases of ABM and CM, where early diagnosis and treatment are essential to avoid poor outcomes, any 'wait and see' attitude by doctors is detrimental.…”

“…These are life-threatening illnesses which require prompt diagnosis and aggressive treatment. [8][9][10][11] Physicians, however, cannot easily distinguish between CM and ABM without cerebrospinal fluid (CSF) analysis. 8 Definitive diagnosis of ABM requires microbiological and biochemical analysis of CSF, obtained by lumbar puncture (LP).…”

“…[8][9][10][11] Physicians, however, cannot easily distinguish between CM and ABM without cerebrospinal fluid (CSF) analysis. 8 Definitive diagnosis of ABM requires microbiological and biochemical analysis of CSF, obtained by lumbar puncture (LP). Lumbar puncture is an invasive procedure that carries with it potential risks and should be carried out only when absolutely necessary.…”

Adult and paediatric mortality patterns in a referral hospital in Liberia 1 year after the end of the war

“…53,54 Severe malaria is sometimes indistinguishable from sepsis 55 or meningitis. 56 Some authors have suggested that a lumbar puncture should be performed systematically in case of convulsions in children. 37 …”