title: Fever and bulging fontanelle mimicking meningitis in an infant diagnosed with benign intracranial hypertension.
abstract: A previously healthy 7-month-old male presented to the emergency department with fever and a bulging anterior fontanelle. A computed tomographic scan of the head suggested mild communicating hydrocephalus. Lumbar puncture was performed, which revealed a normal cerebrospinal fluid (CSF) cell count and glucose concentration, but a markedly elevated opening pressure. DNA polymerase chain reaction for herpes simplex virus performed on CSF was negative; CSF bacterial cultures were without growth. DNA polymerase chain reaction for human herpes virus 6 was strongly positive in serum. Fever and bulging fontanelle resolved within 24 hours. A presumptive diagnosis of transient intracranial hypertension of infancy was made, a form of benign idiopathic intracranial hypertension that mimics the presentation of serious intracranial pathology.
authors.affiliation: Division of Neurology, The Children's Hospital of Philadelphia, Colket Translational Research Center, Philadelphia, PA 19104-4399, USA. goldberge@email.chop.edu
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Goldberg
mesh_terms: D055762:Cranial Fontanelles / Q000473:pathology*; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis*; D011559:Pseudotumor Cerebri / Q000175:diagnosis*