A 14 week old male presents to the ED with lethargy and fever.  He appears ill and has a full fontanelle.  A CT is obtained.  What's the diagnosis?

Answer:  Meningitis with a bulging fontanelle

• Lumbar puncture should be obtained immediately as long as there are no signs of impending herniation on CT
• Most common organisms in this infant over 3 months are streptococcus pneumoniae, Neisseria meningitides and Group B streptococcus
• Treatment in this age group includes vancomycin and ceftriazone or cefotaxime
  
• Complications of meningitis include abscess formation, hydrocephalus, thrombosis, infarct and cerebritis