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A lumbar puncture (spinal tap) is necessary to sample the fluid around the spinal cord and check for bacteria, white cells, sugar, and protein. This will help determine what sort of virus or bacteria is causing the meningitis. Bacterial meningitis causes cloudy fluid, with a high amount of certain types of white blood cells, low sugar, and high protein. Bacteria will grow in blood or spinal fluid in 24 to 48 hours; rapid tests on fluid or blood give results in just a few hours, and are often helpful in identifying the type of bacteria.

Recent antibiotic treatment prior to getting meningitis may make diagnosis more difficult. Lumbar puncture is a safe procedure when done in a large emergency room or in an experienced pediatrician's office, and it is imperative in correctly diagnosing meningitis.

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