{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:16:48Z","timestamp":1747185408018,"version":"3.40.5"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T00:00:00Z","timestamp":1548288000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The literature suggests that certain clinical criteria to determine raised intracranial pressure (ICP) should be met if a patient suspected of meningitis is to undergo a computed tomography (CT) head scan prior to having a lumbar puncture (LP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate whether these criteria were being used by the general medicine department of Auckland City Hospital when requesting CT scans prior to LPs in patients with suspected meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 37 patients admitted under general medicine with suspected meningitis from 1 January to 31 July 2016 were retrospectively audited based on the clinical evidence justifying the decision to do a CT scan prior to a LP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only 7 of 24 patients who underwent CT scans had met clinical criteria for raised ICP. There were no abnormalities found on any of the CT scans and approximately two\u2010thirds of these patients had a final diagnosis of viral illness or headache.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A large number of patients with suspected meningitis under general medicine at Auckland City Hospital are having CT scans without clinical evidence suggestive of raised ICP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13997","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T08:09:35Z","timestamp":1528186175000},"page":"55-58","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Computed tomography head scans prior to lumbar punctures in suspected meningitis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0250-4504","authenticated-orcid":false,"given":"Aqilah","family":"Imtiaz","sequence":"first","affiliation":[{"name":"Department of General Medicine, Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Toomath","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,24]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"JohnsonKS SextonDJ. Lumbar puncture: technique indications contraindications and complications in adults.UpToDate;2016[cited 2016 Dec 23]. Available from URL:http:\/\/www.uptodate.com\/contents\/lumbar\u2010puncture\u2010technique\u2010indications\u2010contraindications\u2010and\u2010complications\u2010in\u2010adults?source=search_result&search=cerebral+herniation&selectedTitle=7%7E89"},{"key":"e_1_2_7_3_1","unstructured":"TunkelA. Initial therapy and prognosis of bacterial meningitis in adults.UpToDate;2016[cited 23 Dec 2016]. Available from URL:http:\/\/www.uptodate.com\/contents\/initial-therapy-and-prognosis-of-bacterial-meningitis-in-adults?source=see_link&sectionName=Avoidance+of+delay&anchor=H6#H6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2009.075598"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066607299516"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010399"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.07.001"},{"key":"e_1_2_7_8_1","unstructured":"National Institute for Health and Care Excellence. Diagnosis of bacterial meningitis and meningococcal septicaemia in secondary care: Cranial CT Examination for Suspected Bacterial Meningitis.London:National Institute for Health and Care Excellence;2015[cited 2016 Dec 22]. Available from URL:https:\/\/pathways.nice.org.uk\/pathways\/bacterial-meningitis-and-meningococcal-septicaemia-in-under-16s#path=view%3A\/pathways\/bacterial-meningitis-and-meningococcal-septicaemia-in-under-16s\/diagnosis-of-bacterial-meningitis-and-meningococcal-septicaemia-in-secondary-care.xml&content=view-node%3Anodes-cranial-ct-examination"},{"key":"e_1_2_7_9_1","unstructured":"Starship. Meningitis.Auckland:Starship Child Health;2016[cited 2016 Dec 23]. Available from URL:https:\/\/www.starship.org.nz\/for-health-professionals\/starship-clinical-guidelines\/m\/meningitis\/"},{"key":"e_1_2_7_10_1","unstructured":"Pharmaceutical Management Agency.Cost Resource Manual Version 2.2 October 2015.Wellington:Pharmaceutical Management Agency New Zealand Government;2015[cited 2016 Dec 23]. Available from URL:https:\/\/www.pharmac.govt.nz\/assets\/pfpa-v2-2-cost-resource-manual.pdf"},{"key":"e_1_2_7_11_1","unstructured":"RadiologyInfo.org. Radiation Dose in X\u2010Ray and CT Exams.Oak Brook:Radiological Society of North America;2016[cited 2016 Dec 23]. Available from URL:http:\/\/www.radiologyinfo.org\/en\/info.cfm?pg=safety-xray"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13997","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13997","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T21:18:44Z","timestamp":1694726324000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/imj.13997"],"URL":"https:\/\/doi.org\/10.1111\/imj.13997","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2019,1]]},"assertion":[{"value":"2018-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}