Exams and Tests

Upon arrival at the emergency department, the child's temperature, blood pressure, respiratory rate, pulse, and oxygen in the blood may be checked. After quickly checking the child's airway, breathing, and circulation, the doctor completely examines the child to look for a focal source of infection, to assess any alteration in mental status, and to determine the presence of meningitis. If meningitis is suspected, several tests and procedures are needed to determine the diagnosis.

• A spinal tap, or lumbar puncture, is an essential procedure in which cerebrospinal fluid is obtained from the child and then analyzed in a laboratory. Cerebrospinal fluid is the fluid surrounding the brain and spinal cord where the infection in meningitis occurs.
  
  
  • To perform this simple procedure, the doctor numbs the skin on the child's lower back with a local anesthetic.
    
    
  • A needle is then inserted into the lower back to obtain the necessary fluid.
    
    
  • The fluid is sent to a laboratory and is checked for white and red blood cells, protein, glucose (sugar), and organisms. The fluid is also sent for culture.
    
    
  • After the needle is removed, a small bandage is placed on the skin where the needle was inserted.
    
    
  • A spinal tap is not a dangerous procedure for a child. The needle is inserted at a location below the end of the main body of the spinal cord. A spinal tap is a simple procedure that is necessary to determine if a person has meningitis. Currently, no other procedure is available to aid in the diagnosis of meningitis.
  
  
• An IV may be started to obtain blood and to give fluids. This helps prevent dehydration and maintain a good blood pressure.
  
  
• Urine may be obtained to determine if any infection is present in the child's urinary tract system.
  
  
• A chest x-ray film may be taken to look for signs of infection in the child's lungs.
  
  
• A CT scan is sometimes necessary if any of the following is present or suspected:
  
  
  • Trauma
    
    
  • Increased brain pressure
    
    
  • Neurologic problem
    
    
  • Lack of fever
    
    
  • Brain abscess
    
    
  • Tumor