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Old 05-21-2014
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Default help , meningitis in children

so in meningitis , we do LP even if fontaneele are bulging and child less than 1 year , according to uworld ,
do ct first only if there si hydrocephalus, coma, focal neuro s/s (does that include , 6,3 cranial palsy ??
uworld q 3633 , really confusing
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Old 05-21-2014
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Originally Posted by hydrocephalus View Post
so in meningitis , we do LP even if fontaneele are bulging and child less than 1 year , according to uworld ,
do ct first only if there si hydrocephalus, coma, focal neuro s/s (does that include , 6,3 cranial palsy ??
uworld q 3633 , really confusing
CN3 and 6 palsy would indicate increased ICP (indication for CT)

in infants there are hardly any signs other than bulging fontanelles that give a clue to suspect meningitis (this is like kernig's and brudzinski's sign)
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CN3 and 6 palsy would indicate increased ICP (indication for CT)

in infants there are hardly any signs other than bulging fontanelles that give a clue to suspect meningitis (this is like kernig's and brudzinski's sign)

that si true but in this q , it state that increase in fontaneele is not considered increase in ICP as THE CHILD IS LESS THAN 1 YEAR which the confusing
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that si true but in this q , it state that increase in fontaneele is not considered increase in ICP as THE CHILD IS LESS THAN 1 YEAR which the confusing
yeah thats what i meant
whenever the only finding is bulging fontanelles u got a green light to do LP
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The fontanelle is open in infants and can sink in dehydration and easily bulge in meningitis therefore probably not taken as a severely increased intracranial pressure. Doll eye movement, focal neurological signs or papilledema however are contraindication to Lp and more sure shot signs of dangerously increased icp. However LP should be avoided in tense bulging fontanelle
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