1 Rush Children's Hospital, Chicago, IL 60612-3833
Wiswell et al1 assert that "if lumbar punctures (LPs) are omitted as part of the early neonatal sepsis evaluation, the diagnosis of bacterial meningitis occasionally will be delayed or missed completely." They call into question a study from our institution as well as several others2-5 that have recently concluded that cerebrospinal fluid (CSF) examination is not indicated in asymptomatic neonates with antepartum risk factors for infection." We would like to raise for discussion the semantics of Dr Wiswell's assertion and the data upon which it is based.