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Is lumbar puncture indicated?

Author: Pediatric Oncall

Question
A 4½-year-old girl presented with headache, fever for 20 days, and vomiting, and left focal convulsion for 1 day. There was no altered sensorium or focal neurological deficit. There was no contact with TB. On examination, she had bradycardia with hypertension and was drowsy. Reflexes were normal. There were no meningeal signs. Other systems were normal. A CT brain showed a ring-enhancing lesion in the right frontotemporal region (high cortical) with perilesional edema. She was treated with steroids, mannitol, and albendazole.

Is a lumbar puncture indicated?

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