Lumbar puncture needles should be repeated in patients with any of the following conditions

1) Persistent or worsening neurological symptoms;

(2) persistent or worsening sepsis;

(3) secondary fever (i.e., re-fever after at least 24 hours without fever);

(4) children treated with dexamethasone;

(5) children with functional asplenia (e.g. sickle cell disease) or other conditions of immune insufficiency;

(6) Repeat CSF at the end of treatment, especially in young infants, to determine whether treatment can be discontinued,

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