NREMT Paramedic Cognitive ExamMedicalMedium
A 6-month-old infant presents with a history of poor feeding, irritability, and a bulging fontanelle. The mother reports the infant has been lethargic and has had a fever (102°F/38.9°C) for the past 12 hours. There are no signs of rash. Which of the following conditions is most likely causing these symptoms?
- AMeningitis
- BFebrile seizure
- CDehydration
- DBronchiolitis
Show answer & explanationAnswer & explanation
Correct answer: A. Meningitis
The combination of fever, irritability, lethargy, and a bulging fontanelle in an infant is highly indicative of meningitis. The bulging fontanelle is a significant sign of increased intracranial pressure, which is a hallmark of meningitis in infants. While other conditions can cause fever and irritability, the bulging fontanelle makes meningitis the most likely and critical diagnosis.
Why the other options are wrong
- B. Febrile seizures are typically associated with rapid temperature rise and resolve spontaneously, without ongoing lethargy or a bulging fontanelle.
- C. Dehydration can cause lethargy and poor feeding, but typically presents with a sunken fontanelle (not bulging) and dry mucous membranes.
- D. Bronchiolitis primarily affects the lower respiratory tract, causing wheezing and respiratory distress, not typically a bulging fontanelle.
Infant Meningitis Signs
Inflammation of the meninges in infants, presenting with non-specific symptoms and often a bulging fontanelle due to increased intracranial pressure.
- Fever, irritability, and lethargy are common.
- Bulging fontanelle is a critical sign of increased ICP.
- Rapid diagnosis and treatment are essential to prevent severe neurological sequelae.
Memory trick: FEVER + FONTANELLE = MENINGITIS ALARM!