A 6-week-old with fever and bulging fontanelle: a case of bacterial meningitis
A branching clinical case simulation for a patient presenting with fever, poor feeding, high-pitched cry, and bulging fontanelle. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 5hard20 min6 stages
- Patient
- 42 years, female
- Presenting complaint
- Fever, poor feeding, high-pitched cry, and bulging fontanelle
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are a Year 5 medical student on a paediatrics rotation at a district general hospital. A 6-week-old baby girl (42 days), Lily Adeyemi, is brought to the emergency department by her mother. The mother reports that Lily has had a fever for 24 hours, is feeding poorly, has been crying with a high-pitched scream, and she noticed a 'soft spot' that feels bulging. The baby is lethargic. The ED is busy, and the senior registrar is in the resuscitation room with another patient. You are asked to see Lily and present your findings. Remember to act promptly and systematically.
What this case teaches
Recognise sepsis and meningitis in a young infant; perform a septic screen including lumbar puncture; start empirical antibiotics covering the age-appropriate organisms without delay; monitor for raised intracranial pressure.
How the case unfolds
- 1Focused HistoryHistory
- 2Physical ExaminationExamination
- 3Septic Screen and Lumbar PunctureInvestigations
- 4Diagnostic ReasoningDiagnosis
- 5Empirical AntibioticsTreatment
- 6Monitoring for Raised Intracranial PressureMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "A 6-week-old with fever and bulging fontanelle: a case of bacterial meningitis"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.