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In general, whenever the diagnosis of meningitis is strongly considered, a lumbar puncture should be promptly performed. Examination of the cerebrospinal fluid (CSF) is the cornerstone of the diagnosis. The diagnosis of bacterial meningitis is made by culture of the CSF sample.
Normally, there should be no bacteria in the bloodstream. Blood cultures are used to identify the bacteria that caused the pneumonia and to guide the choice of antibiotic. A patient's antibiotics may be changed when results of the blood or sputum cultures are completed (usually after 48 to 72 hours).