To the Editor—We congratulate Costerus et al for their informative study on deterioration and death after admission in 1533 adults with acute bacterial meningitis (ABM): The authors conclude that lumbar puncture (LP) might be associated with deterioration in 0.1%–3% of the cases, probably closer to 0.1% [1]. Although commented upon in their discussion, it must be emphasized that ABM may be a fulminant disease with cerebral herniation and death within hours, irrespective of LP [2]. Hence, the observed deterioration may have easily been caused by the natural course of ABM and would have occurred even without LP.

中文翻译：

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细菌性脑膜炎中的腰椎穿刺是安全的：仅在精神状态受损的情况下，腰椎穿刺前没有动机进行颅脑计算机断层扫描

致编辑-我们祝贺Costerus等人对1533例急性细菌性脑膜炎（ABM）成年人入院后的恶化和死亡进行了有益的研究：作者得出的结论是，腰椎穿刺（LP）可能导致0.1％–3％的恶化在这种情况下，可能接近0.1％[1]。尽管在讨论中对此进行了评论，但必须强调的是，无论LP多少，ABM可能都是几小时内脑疝和死亡的暴发性疾病[2]。因此，观察到的劣化可能很容易由ABM的自然过程引起，甚至在没有LP的情况下也会发生。