NREMT Paramedic Cognitive ExamMedicalMedium
A 6-month-old infant presents with a history of poor feeding, irritability, and a bulging fontanelle. The parents report a fever of 102°F (38.9°C) and a recent upper respiratory infection. On assessment, the infant is lethargic and has a high-pitched cry. Which of the following conditions should be highly suspected?
- ABronchiolitis
- BGastroenteritis
- CMeningitis
- DFebrile Seizure
Show answer & explanationAnswer & explanation
Correct answer: C. Meningitis
The constellation of symptoms in an infant, including poor feeding, irritability, fever, bulging fontanelle, lethargy, and a high-pitched cry, are classic signs of meningitis. This is a severe infection of the meninges and requires immediate medical attention.
Why the other options are wrong
- A. Bronchiolitis typically presents with respiratory distress (wheezing, retractions) and cough, not usually a bulging fontanelle or high-pitched cry.
- B. Gastroenteritis involves vomiting and diarrhea, and while it can cause dehydration and lethargy, it typically does not present with a bulging fontanelle or high-pitched cry indicative of increased intracranial pressure.
- D. A febrile seizure is a seizure occurring with a fever, but a bulging fontanelle and persistent lethargy with a high-pitched cry suggest ongoing intracranial pathology beyond a simple seizure.
Infant Meningitis Signs
Key indicators of meningeal inflammation in infants, which can be subtle and non-specific.
- Poor feeding and irritability
- Fever
- Bulging fontanelle
- Lethargy, high-pitched cry
Memory trick: Fever, Fontanelle, Fussiness: Brain Infection Alert!