رضيع عمره ٥ أشهر عنده حمى ٣٩٫٢ منذ يوم، وتهيج وبكاء عالٍ لا يهدأ بالحمل، ورفض للرضاعة، وقيء مرتين. اليافوخ الأمامي منتفخ، والنبض ١٧٦. لا يوجد طفح. ما الأرجح؟

A 5-month-old has had fever 39.2 °C for a day, irritability with a high-pitched cry not settled by holding, refusal to feed and vomiting twice. The anterior fontanelle is bulging, HR 176, and there is no rash. What is most likely?

1. Meningitis
2. Simple constipation
3. Ordinary infant colic
4. Early teething

Answer: A) Meningitis. Infants may lack neck stiffness; signs of meningitis include fever, irritability, high-pitched cry, poor feeding, a bulging fontanelle and drowsiness. Urgent assessment and antibiotics are needed.