• do ValleDaniel AlmeidaDA, Luisa Carolina Vinhal Costa, Amanda Perin Fregonese, Dannyelle Heloize Leite da Silva, Giovana Kellen Souza Maldonado, Letícia Tozzini Tavares da Silva, and Mylena da Silva Couto.
• Hospital Pequeno Príncipe, Curitiba, Brazil.
• Pediatr Emerg Care. 2024 Mar 14.

ObjectiveThe aim of the present study is to evaluate the necessity of performing lumbar puncture in patients experiencing febrile seizures, considering the epidemiology specific to Brazil.MethodsA retrospective cross-sectional study was performed from January 2017 to December 2021.ResultsA total of 469 children with seizure and fever were analyzed. The identified event was the first in 65.9% (n = 309). A total of 54.2% (n = 254) of patients had a simple febrile seizure. Infectious focus, excluding previous central nervous system (CNS) infection, was identified in 35.6% (n = 167) patients. Meningitis was identified in 7.7% (n = 36) patients, all of them were viral. Patients with CNS infection had a higher frequency of symptoms such as nausea and vomiting, drowsiness, headache, and higher level of leukocytosis. A longer duration of fever was found to be more strongly associated with CNS infection.ConclusionsWhen considering the use of lumbar puncture in febrile seizure, it is important to conduct a comprehensive evaluation that considers multiple factors, including clinical signs, symptoms, and the overall clinical context. Meningeal signs may be less prominent, and other symptoms such as lethargy, irritability, and vomiting may serve as more reliable indicators. Although clinical examination suggestive of meningitis remains an important factor, the recurrence of febrile seizures and a longer length of fever can provide additional insights and aid in decision-making regarding lumbar puncture.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

10 keywords...

hide…