Indications for Lumbar Puncture and Cerebrospinal Fluid Analysis in Patients with Suspected Meningitis

Introduction

Lumbar puncture (LP) and cerebrospinal fluid (CSF) analysis play a crucial role in diagnosing meningitis and other neurological conditions. This blog explores the indications, contraindications, and precautions associated with LP.

Indications for Lumbar Puncture

• Suspected bacterial or viral meningitis
• Evaluation of central nervous system (CNS) infections
• Diagnosis of subarachnoid hemorrhage (SAH) when CT is inconclusive
• Assessment of inflammatory or autoimmune disorders affecting the CNS
• Measurement of intracranial pressure in idiopathic intracranial hypertension

Contraindications for Lumbar Puncture

• Presence of elevated intracranial pressure due to mass lesion
• Severe thrombocytopenia or coagulation disorders
• Local skin infection at the puncture site
• Cardiorespiratory instability

Precautions and Best Practices

Prior to performing an LP, clinicians should:

• Perform neuroimaging when intracranial pressure elevation is suspected
• Use sterile techniques to minimize infection risk
• Monitor patient for post-procedural complications such as headaches or bleeding

Conclusion

Lumbar puncture remains an indispensable diagnostic tool. Understanding the indications and precautions ensures safe and effective use in clinical settings.