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Meningitis
Bacterial meningitis can be deadly. The good news: It's on the wane because most children now get immunized with two protective vaccines, Hib and pneumoccocal. Most cases of meningitis (an infection of the spinal fluid and the fluid surrounding the brain) are now viral, not bacterial, and not life-threatening. Still, it's considered an emergency because bacterial meningitis does need to be ruled out.
Classic signs:
Headache
Fever
Stiff neck
Fatigue
The red flag is a fever (even a mild one) and a stiff neck. If your child has both, get him to the ER.
For infants and toddlers, who may not be able to tell you their neck feels stiff, look out for irritability, eating poorly, vomiting -- plus a big fever spike. One clue: paradoxical irritability. "Usually when babies are fussy, they want to be picked up and held, but this often hurts if the spinal cord is inflamed," says Dr. Shaw. A baby may cry more when you change his diaper because it hurts when you lift his legs.
If you've given your child a fever reducer, that's fine, but call your doctor at once if you suspect meningitis. If he's not available, go to the ER immediately. Call 911 if your child's severely lethargic, a possible sign of advanced illness.
In the ER, your child may be given a lumbar puncture to diagnose bacterial meningitis. He'll probably be put on IV antibiotics in case it is bacterial. If it turns out to be viral, he may still need IV fluids if he's dehydrated, as well as pain- and fever-reducing medication, and will stay in the hospital for a day or two. If it's bacterial, he'll stay at least a week, until the meningitis clears.
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