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J Korean Soc Emerg Med > Volume 28(6); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(6): 643-649.
응급실로 내원한 3개월 이하 영아 발열 환자에서 요추천자검사에 대한 고찰
이상엽1, 이현정1*, 김재우1, 문형준1, 이동욱1, 이정원1, 최재형1, 박준수2
1순천향대학교 천안병원 응급의학과
2순천향대학교 천안병원 소아청소년과
Discussion of Lumbar Puncture in Infants Aged Less than 3 Months Who Visited Emergency Department
Sang Yeop Lee1, Hyun Jung Lee1*, Jae Woo Kim1, Hyung Jun Moon1, Dong Wook Lee1, Jung Won Lee1, Jae Hyung Choi1, Joon Soo Park2
1Department of Emergency Medicine, Soonchunhyang University Hospital, Cheonan, Korea
2Department of Pediatrics, Soonchunhyang University Hospital, Cheonan, Korea
Correspondence  Hyun Jung Lee ,Tel: 041-570-3859, Fax: 041-570-3924, Email: silenos@schmc.ac.kr,
Received: June 30, 2017; Revised: July 3, 2017   Accepted: September 29, 2017.  Published online: December 31, 2017.
ABSTRACT
Purpose:
This study was conducted to confirm the necessity of lumbar puncture to identify the cause of fever in febrile infants aged less than 3 months who visited an emergency department.
Method:
This was a retrospective study conducted on 399 infants aged 31 days to 90 days who visited the emergency department with fever from March 2014 to February 2016.
Results:
Of the 399 patients, 49 patients had serious bacterial infections (SBI), and were finally diagnosed with urinary tract infection (UTI), sepsis, and bacterial meningitis. Of these, only one case was diagnosed with bacterial meningitis, and this patient was accompanied by sepsis. UTIs were present in 47 patients, and only 1 case was diagnosed with sepsis without bacterial meningitis or UTI. The Boston criteria and Philadelphia criteria included the cerebrospinal fluid (CSF) results for predicting SBI. In this study, the modified Philadelphia criteria was used, which does not include the CSF results, and there was no factor that showed a significant correlation as a result of statistical analysis. Rather, a C-reactive protein ≥50 mg/L, procalcitonin ≥2 ng/mL, and fever over 39
Key words: Meningitis, Bacterial, Fever, Spinal puncture, Infant
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