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{
    "pk": 7484,
    "title": "Necessity of Lumbar Puncture in Patients Presenting with New Onset Complex Febrile Seizures",
    "subtitle": null,
    "abstract": "Introduction\n: This study aims to characterize the population of patients presenting to a pediatric emergency department (ED) for a first complex febrile seizure, and subsequently assess the rate of acute bacterial meningitis (ABM) occurrence in this population. Furthermore, this study seeks to identify whether a specific subset of patients may be atlesser risk for ABM or other serious neurological disease.\nMethods\n: This retrospective cohort study reviewed the charts of patients between the ages of 6 months to 5 years of age admitted to an ED between 2005 and 2010 for a first complex febrile seizure (CFS). The health information department generated a patient list based onadmission and discharge diagnoses, which was screened for patient eligibility. Exclusion criteria included history of a complex febrile seizure, history of an afebrile seizure, trauma, or severe underlying neurological disorder. Data extracted included age, gender, relevant medical history, descriptions of seizure, treatment received, and follow-up data. Patientspresenting with two short febrile seizures within 24 hours were then analyzed separately to assess health outcomes in this population.\nResults\n: There were 193 patients were eligible. Lumbar puncture was performed on 136 subjects; it was significantly more likely to be performed on patients that presented with seizure focality, status epilepticus, or a need for intubation. Fourteen patients were found tohave pleocytosis following white blood cell (WBC) count correction, and 1 was diagnosed with ABM (0.5% [95% confidence interval: 0.0–1.5, n = 193]). Forty-three patients had 2 brief febrile seizures within 24 hours. Of the 43, 17 received lumbar puncture while in the ED. None of these patients were found to have ABM or other serious neurological disease.\nConclusion\n: ABM is rare in patients presenting with a first complex febrile seizure. Patients presenting only with 2 short febrile seizures within 24 hours may be less likely to have ABM, and may not require lumbar puncture without other clinical symptoms of neurological disease. [West J Emerg Med. 2013;14(3):206–211.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Seizure"
        },
        {
            "word": "bacterial meningitis"
        },
        {
            "word": "Febrile Seizure"
        },
        {
            "word": "lumbar puncture"
        },
        {
            "word": "Medicine"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Healthcare Utilization",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3k73g4h4",
    "frozenauthors": [
        {
            "first_name": "Erin",
            "middle_name": "M",
            "last_name": "Fletcher",
            "name_suffix": "",
            "institution": "San Diego State University, University of California San Diego; University of California, San Diego, Department of Emergency Medicine, San Diego, California; Rady Children’s Hospital, San Diego, California",
            "department": "None"
        },
        {
            "first_name": "Ghazala",
            "middle_name": "",
            "last_name": "Sharieff",
            "name_suffix": "",
            "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California; Rady Children’s Hospital, San Diego, California; University of California, San Diego, Department of Pediatrics, San Diego, California",
            "department": "None"
        }
    ],
    "date_submitted": "2012-06-26T16:09:45Z",
    "date_accepted": "2012-06-26T16:09:45Z",
    "date_published": "2013-02-15T18:53:30Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7484/galley/4420/download/"
        }
    ]
}