本文复习了1973～1977年间111例细菌性脑膜炎患儿及其诊断拖延的原因。脑脊液培养阳性者95例,最常见的感染细菌为奈瑟氏脑膜炎球菌占52%;流感嗜血杆菌占39%;肺炎球菌占6%。其中有6例,尽管早期进行腰穿,仍未及时明确诊断,而每例都是奈瑟氏脑膜炎球菌,其中两例脑脊液(CSF)细胞学检查正常,但其后的培养为阴性。强调了不论CSF细胞学结果如何,标本都应作细菌培养的重要性。另外4例的首次CSF细胞检查正常,涂片阴性,培养亦无细菌生长。但再次腰穿(间隔分别为24小时、48小时、36小时和11天)则确证为脑膜炎球菌性脑膜炎。鉴于细菌性脑膜炎常为败血症所致,故对首次CSF正常的败血症患儿,如果临床情况允许,须行进一步腰穿。但是在败血症患儿,腰穿本身可以在实际上引起 This article reviewed 111 children with bacterial meningitis from 1973 to 1977 and the causes of delayed diagnosis. Cerebrospinal fluid culture positive in 95 cases, the most common bacterial infection for Neisseria meningitidis 52%; Haemophilus influenzae 39%; pneumococcus 6%. Six of these cases, although lumbar puncture was performed early, have not yet been diagnosed in time, and in each case Neisseria meningitidis, two of whom had normal cytology of cerebrospinal fluid (CSF) cytology but were subsequently negatively cultured. The importance of bacterial cultures should be emphasized regardless of CSF cytology results. In the other 4 cases, the first CSF cell test was normal, the smear was negative, and no bacteria were cultured. However, lumbar puncture again (interval 24 hours, 48 ​​hours, 36 hours and 11 days) was confirmed as meningococcal meningitis. In view of bacterial meningitis is often caused by sepsis, so the first normal CSF of children with sepsis, if clinical circumstances permit, to be further lumbar puncture. However, in children with sepsis, lumbar puncture itself can actually cause