0
Special Feature |

Radiological Case of the Month FREE

Els Bruneel, MD; Philippe Gillis, MD; Marc Raes, MD; Peter Donkersloot, MD; Hendrik Duyvendak, MD; Philippe Alliet, MD; Beverly P. Wood, MD
[+] Author Affiliations

Section Editor: Beverly P. Wood, MD


Arch Pediatr Adolesc Med. 1998;152(3):297-298. doi:10.1001/archpedi.152.3.297.
Text Size: A A A
Published online

A 2-MONTH-OLD boy presented with a 7-day history of fever. Despite antibiotic therapy for pharyngitis, his fever persisted and he started to vomit and became irritable. On 2 occasions, the mother noticed short myoclonic contractions of the left arm and leg .

Medical history includes a fever on the second day of life, attributed to viral gastroenteritis.

Physical examination showed an irritable infant with macrocephaly (head circumference, 42.5 cm; 97th percentile, 42 cm) and gray, poorly perfused skin. The anterior fontanel was bulging and his eyes demonstrated a sunset sign. He lay spontaneously with his neck extended. The peripheral blood showed a white blood cell count of 24.9× 109/L. The blood culture was sterile. Results of a lumbar puncture and analysis of the cerebrospinal fluid showed a white blood cell count of 4.3×109/L, a protein concentration of 226 g/L, and a glucose concentration of less than 0.5 µmol/L (<10 mg/dL). No bacteria were detected microscopically. The cerebrospinal fluid culture was sterile.

Cranial ultrasonography and cranial computed tomography were performed (Figure 1). Figure 2 shows a computed tomographic scan after 10 weeks of antibiotic therapy.

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
JAMAevidence.com

The Rational Clinical Examination
Evidence Summary and Review 2

The Rational Clinical Examination
Location of Paracentesis and Ultrasound Guidance