Bacterial meningitis in febrile young infants acutely assessed for presumed urinary tract infection: a systematic review

Conclusion: Co-existing bacterial meningitis in febrile young infants with urinary tract infection is rare. In those meeting low-risk criteria, a lumbar puncture may not be indicated. A case by case assessment should be made in infants not meeting low-risk criteria.Trial registration: CRD42018105339What is known:•When caring for febrile infants ≤ 3 months with urinary tract infections, clinicians may have uncertainty on whether to perform a lumbar puncture (LP) for possible co-existing meningitisWhat is new:•An up-to-date systematic review of 20 studies found the frequency of co-existing meningitis in this population to be between 0 and 2.1%•Despite limited data, an LP may not be indicated in infants meeting low-risk criteria (being well-appearing, age  >  21 days, procalcitonin ≤ 0.5 ng/ml, C reactive protein ≤ 20 mg/L). Ill-appearance and neonatal age appear to be significant risk factors of co-existing meningitis
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research