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Radiological Case of the Month
Laura M. Ibsen, MD
From the Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Oregon Health Sciences University, Portland.
Arch Pediatr Adolesc Med. 2002;156:293-294.
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A PREVIOUSLY healthy 16-year-old boy was brought to the emergency department
with a 1-day history of fever, headache, and lethargy. On that day, he vomited
several times, was disoriented, and was incontinent. The physical examination
results were notable for confusion, meningismus, and anisocoria.
Results of a lumbar puncture showed an opening pressure of 55 cm H2O. The cerebrospinal fluid (CSF) was grossly purulent. Laboratory test
results were white blood cell count, 17 x 103/µL (59%
segmented neutrophils, 37% band forms); glucose, 20 mg/dL (1.11 mmol/L); and
protein, 5.83 g/dL. A gram stain of the CSF showed intracellular gram-negative
diplococci. Treatment was started with ceftriaxone, 75 mg/kg and mannitol,
0.5 g/kg. A computed tomogram of the brain was normal and showed unremarkable
cisterns and ventricles. On arrival after transfer to a tertiary hospital,
his blood pressure was 168/100 mm Hg and his heart rate was . . . [Full Text of this Article]
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Variation in the use of intracranial-pressure monitoring and mortality in critically ill children with meningitis in the United States.
Odetola et al.
Pediatrics 2006;117:1893-1900.
ABSTRACT
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