Age (months) | 3 | 9.5 | 15 | 26 |
Gender | M | M | F | F |
PMH | Healthy | Ex-premature Cerebral palsy VP shunt in situ Hydrocephalus | Healthy | Healthy |
Preceding symptoms | Irritable hours before | Intermittent pyrexia × 1/52 | Intermittent pyrexia × 1/7 | Nil |
Temperature | 38.2°C | 38.1°C | 38.8°C | 39.1°C |
Seizure | | | | |
Focal features | No | Yes | Yes | No |
Characteristics | Continuous | Intermittent | Continuous | Continuous |
Type | Tonic-clonic | Tonic | Tonic-clonic | Tonic-clonic |
Duration (h) | 0.5–1 | >2 | 1–2 | 1–2 |
Meningism | Absent | Absent | Absent | Absent |
Rash | Nil | Nil | Nil | Nil |
WBC (×1012/l) | 38.4 | 19.1 | 21.3 | 5.1 |
Neutrophils (×1012/l) | 28.1 | 12.0 | 17.2 | 1.6 |
C reactive protein (mg/l) | 285 | 52 | 279 | 64 |
Preliminary diagnosis | ABM | Infected VP shunt | PFC | PFC |
Immediate antibiotics | Yes | Yes | Yes | No |
Outcome | Severe neurological deficits | Death | Death | Death |
Organism in CSF |
S pneumoniae
|
S pneumoniae
|
S pneumoniae
|
N meningitidis
|