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J Clin Med. 2013 Dec 17;2(4):328-30. doi: 10.3390/jcm2040328.

Repeat Lumbar Puncture: CSF Lactic Acid Levels are Predictive of Cure with Acute Bacterial Meningitis.

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Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.
School of Medicine, State University of New York, Stony Brook New York, NY 11501, USA .


A common clinical problem concerns the utility of repeat lumbar puncture (LP) in adults with acute bacterial meningitis (ABM), e.g., pneumococcal meningitis [1]. An LP is initially done for diagnostic purposes in patients with suspected ABM, i.e., diagnostic lumbar puncture (DLP). A repeat LP (RLP) may be done 1-3 days after the initial DLP, if the patient shows no improvement. If a patient with ABM is not doing well after three days, adequacy of antimicrobial therapy is the main concern. Other reasons for RLP is to detect possible intracranial complications of ABM unrelated to adequacy of therapy [1-2].

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