
Second Lumbar Puncture in Aseptic Meningitis
C. Richard Magnussen, MD
Department of Medicine St Mary's Hospital 89 Genesee St Rochester, NY 14611
Arch Neurol. 1980;37(6):398-399.
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To the Editor.—
Differentiation of bacterial from aseptic meningitis must be made promptly and accurately. The CSF WBC differential in aseptic meningitis often exhibits a polymorphonuclear leukocyte predominance early in the course of the infection.1 The article by Varki and Puthuran (ARCHIVES 36:581-582, 1979) corroborates this phenomenon in ten adults with aseptic meningitis, all of whom demonstrated a "significant fall" in the percent of polymorphonuclear leukocytes 18 to 48 hours after the initial lumbar puncture (LP). The authors are to be complimented for what is, to our knowledge, the first prospective analysis of serial changes in differential WBC counts of CSF in patients with uncomplicated aseptic meningitis.
The authors reported their data in terms of "mean" values of polymorphonuclear leukocytes measured at the time of the second LP compared with that at the time of the initial LP, and commented that a second analysis performed 18 to 48
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