Patient with Suspected Meningitis Age > 56 days
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Front-line Ordering Clinician (FLOC)/RN Team Assessment
  • Sepsis huddle as clinically indicated
  • History & Physical
  • IV access, Recommended Labs
  • Consider LMX (lidocaine) cream to lower back
  • Consider NPO status for lumbar puncture (LP), imaging
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Proceed with LP
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Perform LP, send CSF Studies
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Unable to obtain CSF
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Await results of LP before starting antibiotics
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CSF Findings Consistent
with Bacterial Meningitis
CSF Findings Not Consistent
with Bacterial Meningitis
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CSF Findings Consistent
with Bacterial Meningitis
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Consider Other Diagnoses including focal bacterial infection (parameningeal abscess or empyema) and HSV encephalitis
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Delay LP
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Start Antibiotics,
Perform LP
if/when able
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Inpatient Discharge Planning    Consultant Follow-up
Posted: December 2017
Authors: Y. Chang, MD; J. Bergelson, MD; M. Hayes, Pharm. D; B. Ku, MD; J. Huh, MD; K. Chiotos, MD; M. Sergonis, MD ; T. Kaur, MD; B. Greywood, MD; J. McGuire MD, MSCE; S. Rosanova, RN; A. Marchegiani, AuD; S. Weiss, MD; E. Graf; L. Akhtar, MD, PhD