kermina
Forum Newbie
Topics: 4
Posts: 21
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i've a simple question may be i'm just confused in diagnosis of encephalitis as written in kaplan notes the LP is preferred over the CT, since the main criteria of the disease is altered mental status ranging from mere confusion to coma, wasn't that a contraindication for LP when was discussed in meningitis
please help me in this confusion, what is the best initial management and the best initial diagnostic test
thanks
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| cirus
Forum Guru
Topics: 108
Posts: 740
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Neuro symp + fever.
1st step---> Fundus exam for papilledema
+ve--->CT 1st
-ve--->LP.
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| kermina
Forum Newbie
Topics: 4
Posts: 21
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thanks for the answer,
what about the management, do we wait for ct/lp or we give treatment first?
thanks
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| cirus
Forum Guru
Topics: 108
Posts: 740
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Depends,
If u have no clue what it is, then CSF analysis first & gm stain., but don't wait for cults as the CSF analysis will give a strong idea about if its of bact, viral, or fungal
but for example, in lyme, give ceftriaxone first even before LP
for HIV pt with encephalitis & CT with temp hge-->treament before results.
hope that helps
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| liliaeliz
Forum Elite
Topics: 40
Posts: 372
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focal neurol.simp.,papilledema,alt. mental status do ct scan first
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| kermina
Forum Newbie
Topics: 4
Posts: 21
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thanks
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