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Bulging fontanel during a measles infection
Kübra Şahin1, Gülsüm İclal Bayhan2, Başak Alan1
1MD, Yildirim Beyazit University, Faculty of Medicine, Department of General Pediatrics, Ankara City Hospital, Children's Hospital, Üniversiteler Mahallesi 1604., Cadde no: 9, Çankaya, Ankara, Turkey.
Insights
Transient intracranial hypertension, a rare cause of bulging fontanelles in infants, can occur during measles infection. This condition resolved spontaneously in a young child diagnosed with measles.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Bulging fontanels in infants can indicate serious conditions like meningitis or hydrocephaly.
- Transient intracranial hypertension is a less common cause of acute fontanel bulging.
Observation:
- A 7-month-old female presented with fever, cough, nasal discharge, and a bulging fontanel.
- Cranial ultrasound and cerebrospinal fluid tests were normal; however, measles infection was confirmed via positive IgM and PCR tests.
Findings:
- The infant's symptoms, including fontanel bulging and irritability, resolved within 24 hours of admission.
- Measles infection was identified as the cause of transient intracranial hypertension in this case.
Implications:
- This case suggests that measles infection can precipitate transient intracranial hypertension in infants.
- Further research into the pathogenesis of transient intracranial hypertension during viral infections is warranted.
Introduction:
Introduction Causes of a bulging fontanel in children include viral/bacterial meningitis, encephalitis, hydrocephaly, intracranial bleeding, psedotumor cerebri and central nervous system tumors. A less well-known cause of acutely-developing fontanel bulging is transient intracranial hypertension.
Case Report:
A 7-month-old female was brought to our hospital with fever, cough, watery nasal secretion and bulging fontanel for the last 3 days. The cranial ultrasound examination and cerebrospinal fluid examinations were normal. The patient's irritability and fontanel bulging improved the day after admission but a maculopapular rash developed. The measles Ig M was positive. Measles PCR was positive from urine and nasopharyngeal swab samples. The signs of intracranial hypertension of the patient recovered completely the day after admission and did not recur during the follow-up. The patient was discharged on the 5th day of admission.
Discussion:
Transient intracranial hypertension is thought to result from a transient increase in the quantity of the circulating cerebrospinal fluid but the pathogenesis is not clear.
Conclusions:
Based on this case, we report that transient intracranial hypertension could develop during a measles infection.
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