Difficulties in the diagnosis of meningitis – a challenging case of a child with head injury

Abstract

Meningitis is a potentially life-threatening condition. The clinical manifestation can vary depending on the age of the child. This report presents the case of a 7-year-old male patient who was admitted to ED due to loss of consciousness after a head injury. Upon admission, the patient had seizures. Head CT scan did not show any signs of intracerebral bleeding or cerebral oedema. During hospitalization in the ICU, the patient began to be febrile and inflammatory markers started to rise. Treatment with antibiotics and antiviral agents was administered. Later, meningeal signs were observed. Additional imaging tests revealed ambiguous findings. The patient's symptoms resolved gradually, and he was discharged after 19 days of hospitalization. The final diagnosis was meningitis. This case highlights that the diagnosis of meningitis requires careful investigation and precise examination. This diagnosis should therefore be considered in all patients who present with symptoms concerning for meningitis.

Management of seizures in children in primary health care

“…Both physical examination and medical history must be very accurate. It should also be borne in mind that a seizure may be a symptom of or lead to serious life-threatening conditions, such as meningitis (25) , stroke (26) , and sudden cardiac arrest. In the latter case, cardiopulmonary resuscitation should be started immediately.…”