Published online July 23, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. e428-e431 (doi:10.1542/peds.2006-2727)
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EXPERIENCE & REASON

Pneumococcal Meningitis Presenting With a Simple Febrile Seizure and Negative Blood-Culture Result

Allison Golnik, MD

Division of General Pediatrics, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota

ABSTRACT

A 12-month-old girl with occult bacterial meningitis presented with a simple febrile seizure. On examination, the patient was alert, interactive, and smiling responsively without meningeal signs, focal neurologic findings, or signs of extreme illness. Her parents were reluctant to allow a lumbar puncture, and the patient was admitted for observation without lumbar puncture. Her fever resolved, and she was playful, had good oral intake, and was discharged 24 hours after admission. Her initial blood-culture result remained negative. Within 24 hours of discharge, the patient had a focal febrile seizure, came back to the hospital, and was found to have meningitis with a penicillin-susceptible, nonvaccine Streptococcus pneumoniae strain 12F.

Key Words: febrile seizures • pneumococcal meningitis

Abbreviations: WBC, white blood cell • CSF, cerebrospinal fluid • AAP, American Academy of Pediatrics

Accepted Jan 26, 2007.