Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Neurol. Jul 31, 2023; 9(4): 37-43
Published online Jul 31, 2023. doi: 10.5316/wjn.v9.i4.37
Role of lumbar puncture in clinical outcome of suspected acute bacterial meningitis
Arunava Saha, Shihla Shireen Kanamgode, Sarat Chandra Malempati, Sirshendu Chaudhuri, Jeffrey Scott
Arunava Saha, Shihla Shireen Kanamgode, Sarat Chandra Malempati, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Sirshendu Chaudhuri, Assistant Professor, Indian Institute of Public Health, Hyderabad 500030, Telangana, India
Jeffrey Scott, Department of Pulmonary and Critical Care Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Saha A, Kanamgode SS and Scott J were involved in the conception of idea and study design; Chaudhuri S and Scott J provided administrative support; Scott J helped in provision of study materials or patients; Saha A, Kanamgode SS and Malempati SC were involved in collection and assembly of data; Saha A, Chaudhuri S and Scott J were involved in data analysis and interpretation; All authors were involved in manuscript writing; and the final draft was approved by all authors.
Institutional review board statement: The study-protocol was approved by the Ethics Committee of Metrowest Medical Center, IRB#2023-005.
Informed consent statement: Informed consent was waived as it was a retrospective chart review.
Conflict-of-interest statement: The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at It was a retrospective study, hence consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Arunava Saha, MD, Department of Internal Medicine, Saint Vincent Hospital, 123, Summer Street, Worcester, MA 01608, United States.
Received: May 20, 2023
Peer-review started: May 20, 2023
First decision: June 15, 2023
Revised: June 26, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: July 31, 2023
Core Tip

Core Tip: Cerebrospinal fluid (CSF) analysis is considered the gold standard for diagnosing meningitis, but often CSF results are unavailable and patients are treated empirically. There are a multitude of reasons for lumbar puncture (LP) deferral, predominantly unsuccessful attempts and body habitus. A lack of CSF analysis in patients with suspected meningitis is associated with prolonged antibiotic use in some and poor outcome in others secondary to potential under-treatment. Every patient with a clinical suspicion for meningitis should undergo LP, radiology-assisted if necessary, and have a CSF analysis to confirm or rule out meningitis to guide need for antibiotic therapy.