Definition
- Are convulsions that occur in a child who is between 3 months and 6 years of age and who has a temperature greater than 38 °C
Number
- Occur between 12 and 18 months of age.
- Most seizures occur when the temperature is higher than 102.2 °F (39 °C).
Clinical presentation
- In children under 1 year old,
- A fever and seizures may be the sole presentation of bacterial meningitis.
- Neck stiffness
- Bulging fontanelle
- Nonspecific symptoms may also be present but their absence does not exclude bacterial meningitis.
Treatment
- Antibiotics should be administered as soon as possible
- Lumbar puncture should be performed if safe, but should not delay administration of antibiotics (it is possible to do both bacterial and viral PCR on CSF),
- In a child without clinical features of raised ICP or focal neurological signs do not delay lumbar puncture to perform a CT head
- If these signs are present, CT head should be done urgently to exclude alternative intracranial pathology or complications of meningitis requiring neurosurgical intervention).
- A dose of dexamethasone can be given with antibiotics in children over 3 months if lumbar puncture shows frankly purulent CSF, CSF WCC > 1000/μl, meningitis with protein count > 1 g/l, bacteria on Gram stain
- But may be harmful in tuberculous meningitis if given without antituberculous therapy
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