An Infant With COVID-19 Presenting With a Bulging Fontanel: A Case Report and Literature Review

An Infant With COVID-19 Presenting With a Bulging Fontanel: A Case Report and Literature Review

A bulging fontanel is a sign of elevated intracranial pressure, which can be caused by diseases with intracranial fluid retention or swelling of the cerebral parenchyma. We experienced a case of an infant with a typical course of mild coronavirus disease 2019 (COVID-19) but with a bulging fontanel a...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) Vol. 16; no. 7; p. e63667
Main Authors: Kuroda, Hiroyuki, Kusama, Yoshiki, Ogura, Ayu, Matsunaga, Takashi, Atsumi, Yukari, Kamimura, Katsunori
Format: Journal Article
Language:English
Published: United States Cureus Inc 02-07-2024
Cureus
Subjects:
Antibiotics
Babies
Case reports
Cerebrospinal fluid
COVID-19 vaccines
Drug resistance
Emergency medical care
Emergency Medicine
Fever
Glucose
Hospitals
Hydrocephalus
Infections
Infectious Disease
Intracranial pressure
Kinases
Laboratories
Leukocytes
Literature reviews
Meningitis
Patients
Pediatrics
Proteins
Tomography
Viral infections
covid-19
pediatric meningitis
antimicrobial stewardship
infant health
bulging fontanelle
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Summary:A bulging fontanel is a sign of elevated intracranial pressure, which can be caused by diseases with intracranial fluid retention or swelling of the cerebral parenchyma. We experienced a case of an infant with a typical course of mild coronavirus disease 2019 (COVID-19) but with a bulging fontanel as a finding at presentation. The patient, a three-month-old boy with no underlying conditions, presented to the emergency clinic with fever, vomiting, and loss of appetite. Due to the absence of crying and the bulging fontanel, he was referred to our hospital with suspected bacterial meningitis. The diameter of the anterior fontanel was 2.5 cm, as measured by the Popich and Smith method. He showed no signs of consciousness impairment and appeared to be as active as usual. Computed tomography revealed a bulging fontanel. Cerebrospinal fluid examination showed no elevated cell counts, and cultures were negative. Accordingly, bacterial meningitis was ruled out. The fever resolved on the day after admission, and the patient was discharged on the third day after admission in good general condition. When an infant diagnosed with COVID-19 presents with a bulging fontanel, it is important to be aware of its low specificity and excessive antibiotic treatment should be reconsidered.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.63667