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Pediatric Rounds Review Questions
Fever and Seizure Activity in a 10-Month-Old Boy

Answer 1

  1. Intravenous antibiotics. Antibiotics should be given on suspicion of meningitis and should not be delayed for pending scans or difficult lumbar punctures. Ideally, cerebrospinal fluid should be obtained prior to antibiotic administration. However, this patient’s findings are concerning for increased intracranial pressure, and computed tomography of the head should therefore be obtained prior to a lumbar puncture. Steroid administration remains controversial and is not routinely recommended in these cases. Magnetic resonance imaging of the head may be obtained later in the patient’s course but should not be part of her initial management.

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