Jeffery P. Hogg, MD

A 5-month-old girl was brought to her local emergency department because she displayed increasing fussiness and back arching for 3 days. She vomited once and was febrile on the day of presentation. Meningitis was suspected. A lumbar puncture was performed. It revealed a cerebrospinal fluid (CSF) protein level of 120 mg/dL and a CSF white blood cell count of 10/µL, with 50% polymorphonuclear cells. Antibiotics were empirically administered, and the infant was transferred to a tertiary care facility for further treatment.