Infections of the Nervous System

exp date isn't null, but text field is

The usual presentation is with:

• headache and fever
• and/or altered level of consciousness
• and/or neck stiffness
• and/or focal neurological signs
• and/or seizures.

In infant's irritability, lethargy and failure to suck are important signs. Neck stiffness is an unreliable sign under one year of age, but the detection of a bulging fontanelle supports the diagnosis.

Differential diagnosis

Headache and fever only: look for cause of fever in other systems (for example, chest, respiratory tract; urinary tract, etc.). Always do malaria slides.

If there is altered level of consciousness, neck stiffness, focal signs or seizures in the presence of fever, or fever with lethargy and failure to suck in infants:

Give:

Medicine	Adult dose	Frequency	Duration
benzylpenicillin iv/im	3g (5MU)	one dose	refer

Note: for dose in children see chapter on Paediatric conditions

Transfer urgently to a secondary care centre.