Step II LP and meningitis

[britesky89]

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hi guys,

I have a question. LP is contraindicated in increased ICP. So why is it used in meningitis? Isn't the ICP increased in meningitis due to inflammation of the meninges ?

 

[Nabin]

Speaking pathophysiologically, increased ICP can be present in Meningitis, but whether that's enough to warrant a CT scan? Almost never. There are some indications where you might need to do a CT scan before going for LP in patients with Meningitis, like immunocompromised patient, new-onset seizures, hx of previous CNS disease, papilledema, focal deficits, etc. If these are present, you need to go for a CT scan. A mild mass effect may be seen in only a handful of patients with meningitis, but even those patients undergo LP without any brain herniation risk.

 

[britesky89]

Thank you @Nabin