By vgreene, 23 August, 2017 Consider LP to r/o meningitis; R/O UTI, esp if pt at increased risk;1 base decision to obtain CXR on clinical findings
By vgreene, 23 August, 2017 If no obvious source of infxn, consider CXR if pt has any of: cough, hypoxia, rales, high fever (≥39°C), fever duration >48h, or tachycardia/tachypnea out of proportion to fever [B]
By vgreene, 23 August, 2017 If starting abx, or if urine dipstick neg and UTI still suspected: Obtain urine cx [C]
By vgreene, 23 August, 2017 Consider UA and cx esp if UTI risk factors1 present, even in presence of viral infxn3 [C]. Base dx of UTI on any of: urine leukocyte esterase, nitrites, leukocyte count, or Gram stain [B]
By vgreene, 23 August, 2017 If LP deferred, ensure close f/u by either: admitting pt, arranging close f/u w/ PCP, or rechecking pt in the ED [C]
By vgreene, 23 August, 2017 Consider LP in all pts;2 if viral illness diagnosed, consider deferment of LP (given lower risk of meningitis)—withhold abx unless another bacterial source identified [C]
By vgreene, 23 August, 2017 Consider LP to r/o meningitis; however, if viral illness diagnosed, may defer LP, but close f/u needed
By vgreene, 23 August, 2017 If LP deferred, withhold abx unless another bacterial source identified; ensure close f/u by either: admitting pt, arranging close f/u w/ PCP, or rechecking pt in the ED [C]
By vgreene, 23 August, 2017 If viral illness diagnosed, consider deferment of LP given lower risk of meningitis [C]
