A-28-days old boy, born after a normal pregnancy and delivery, presents to the emergency department with a one-week history of fever, irritability, poor feeding, and right-sided focal seizures. Before 10 days of this incidence, his elder brother had developed symptomatic pharyngitis with the congested throat, sore, and fever; which was not investigated, and recovered after a 1-week treatment with an antibiotic. Examination The patient looked ill and irritable, but vital signs were stable.
Normal anterior fontanel with no neurological deficit. White blood cells (WBC): 33,600/mm3 Differential count: 61% Neutrophils, 6% Monocytes, 18% Lymphocytes, and 10% Eosinophils. C-reactive protein: Positive Cerebrospinal fluid (CSF): Turbid with 23,520 WBC/mm3 (82% Neutrophils, 18% Lymphocytes) and 3 RBC/mm3 CSF protein: 502 mg/dl, Glucose: 5 mg/dl Latex antigen test: Negative for Hemophilus…
