Bacterial meningitis: causes for concern. The Research Committee of the BSSI.

The case notes of 305 patients admitted to hospitals in the U.K. with a diagnosis of bacterial meningitis were studied retrospectively and several items of concern emerged. These included: no antibiotics given to patients (82.6%) pre-admission and blood cultures and throat swabs were not obtained routinely. From the figures presented lumbar puncture appeared to be justified in patients without contraindications. About half the patients with a rash would have remained undiagnosed without a lumbar puncture even if allowance was made for those who did not have a blood culture.