Contraindications for lumbar puncture in suspected acute bacterial meningitis9
| Signs suggesting raised intracranial pressure |
| Reduced or fluctuating level of consciousness (Glasgow coma scale score <9 or a drop of 3 or more) |
| Relative bradycardia and hypertension |
| Focal neurological signs |
| Abnormal posture or posturing |
| Unequal, dilated, or poorly responsive pupils |
| Papilloedema |
| Abnormal ‘doll's eye’ movements |
| Shock |
| Extensive or spreading purpura |
| Convulsions |
| Coagulation abnormalities |
| Coagulation results (if obtained) outside the normal range |
| Platelet count below 100×109/litre |
| Receiving anticoagulants |
| Local superficial infection at the lumbar puncture site |
| Respiratory insufficiency |