Hospital management of Bacterial Meningitis in adults.

Lumbar puncture contraindications

• Lumbar puncture is contraindicated in the following circumstances:
• Platelet count <50
• INR>1.2 (always check if suspected liver disease or on warfarin)
• Known bleeding disorder (eg haemophilia)
• Evidence of raised intracranial pressure; obtunded (GCS<13), papilloedema, mass effect, cerebral oedema and other features on CT, convulsions (in context of suspected intra-cranial infecion)
• Meningococcal septicaemia (purpuric rash)
• If in doubt, avoid LP until discussed with a senior

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

Read our copyright and disclaimer statement