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Fever and Stiff Neck
Sara C. McIntire, MD;
Michael Green, MD, MPH
Arch Pediatr Adolesc Med. 2001;155:603-606.
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Clinical Presentation: An 11-month-old boy
was seen in the emergency department by his pediatrician for evaluation of
fever (body temperature, 38.5°C) and a stiff neck. The patient's illness
began 5 days earlier when he developed nasal congestion and fever. His pediatrician
prescribed amoxicillin on the third day of illness. The fever persisted, however,
and by the fifth day, the patient was irritable and refused to flex his neck.
New symptoms reported in the emergency department included decreased
activity, poor intake of food and fluids, and decreased urine output. The
parents also reported that after 1 day of amoxicillin therapy, the patient
developed a faint red rash over his trunk, arms, and legs. The rash faded
after 2 days. Symptoms of confusion, headache, conjunctivitis, cough, vomiting,
or diarrhea were denied; however, the parents reported that his usual "noisy
breathing" seemed worse. Medical history . . . [Full Text of this Article] COMMENT
From the Diagnostic Referral Service (Dr McIntire) and the Division
of Allergy, Immunology, and Infectious Disease (Dr Green), University of Pittsburgh
School of Medicine, Pittsburgh, Pa.
Corresponding author and reprints: Sara McIntire, MD, University
of Pittsburgh School of Medicine, Division of Allergy, Immunology, and Infectious
Disease, 3705 Fifth Avenue at Desoto Street, Pittsburgh, PA 15213.
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