Lumbar Puncture in The Frail Infant

To the Editor:— The review article by Alexander concerning lumbar puncture techniques (201:316, 1967) reminds me of untoward effects I have observed, associated with lumbar punctures in infants and children. Seven years ago one of my most respected colleagues was called to the hospital to examine an infant about 1 year of age who had been admitted the previous day with presumptive diagnosis of iron deficiency anemia and a probable ventricular septal defect. Physical examination had revealed an irritable febrile infant with no new physical findings other than a questionably stiff neck. Early meningitis was possible. The infant was mummied and, struggling, was arched transversely across the upper part of the abdomen of the nurse. The procedure did not take an inordinate amount of time and the spinal fluid was clear. When the procedure was completed, the infant, unwrapped, was limp. There was no respiration or heart beat. Attempts