Indian Journal of Critical Care Medicine
Medknow Publications on behalf of the Indian Society of Critical Care Medicine
Vol. 9, No. 3, 2005, pp. 176-178
Bioline Code: cm05028
Full paper language: English
Document type: Research Article
Document available free of charge
Indian Journal of Critical Care Medicine, Vol. 9, No. 3, 2005, pp. 176-178
© Copyright 2005 Indian Journal of Critical Care Medicine.
Postmortem cerebrospinal fluid analysis in a general intensive care unit.|
Hasani Mansour, Sahraian Mohammad Ali, Motamedi Mahmoud, Mostehaghan Kamran
Background and Aim: Infection is a common problem in intensive care medicine and many patients are treated aggressively and empirically with broad-spectrum antibiotics. Meningitis may be missed in intensive care unit (ICU) because some of these patients have fever and altered mental status from another illness and may be treated with impression of sepsis. In order to identify undiagnosed meningitis in ICU admitted patients, postmortem CSF analysis was performed immediately after death. Subjects and Methods: During 1 year, 43 patients underwent lumbar puncture after death. Samples were collected and analysis for cells, sugar and protein concentrations were obtained. Demographic characteristics and diagnosis of the patients were recorded and data analysis was performed by SPSS version 11.5. Results: CSF was completely normal in 62.8% of the patients and it was compatible with meningitis in two of them. Both of them had admitted with impression of sepsis and had another source of infection. Considering a subgroup of the patients who admitted to ICU with impression of sepsis, they were statistically significant. There was no significant difference between surgical and nonsurgical patients. Conclusions: Our findings suggest that meningitis may be missed in ICUs, and more liberal use of CSF analysis should be considered in critically ill patients, especially those who referred with impression of sepsis.
Cerebrospinal fluid, meningitis, critical care, missed diagnosis
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