What's the Diagnosis? By Dr. Lauren Murphy

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