Intracranial Infections Case 3

Intracranial Infections Case 3

  1. 1. Question

    A 4-week-old baby girl is brought into the ED by her mother who is concerned that she is off her feeds and less active than normal.

    She was born at 38/40, following spontaneous vaginal delivery, and went home from hospital with mum the next day.

    She seems floppy, but cries when examined:

    • Chest is clear
    • CRT <2 seconds
    • Temp 34.7ºC

    She has a few non-blanching spots, which mum states were not there this morning.

    You are concerned about the possibility of bacterial meningitis.

    After initial ABC assessment, what is your immediate course of action?

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  2. 2. Question

    How much fluid would you give to this infant?

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  3. 3. Question

    You ask the nurse to prepare a trolley to perform an LP. She comes back to you with blood results showing a Normal CRP and low peripheral WBC count. Does this alter your decision to perform an LP?

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  4. 4. Question

    You are concerned that the administration of antibiotics before an LP will reduce the chances of identifying the causative organism.

    What else can you request aside from a gram stain and cultures?