Bulging fontanelle as a sign of COVID-19 infection in infant A case report

Rationale

Coronavirus disease 2019 (COVID-19) is a new viral infection caused by the severe acute respiratory syndrome coronavirus 2. Fortunately, mortality rates in children are very low compared to those in the elderly, and 80% of children have mild infections or are asymptomatic. Despite this, neurological manifestations in younger children are not always documented because of difficulties arising from poorly developed communication that makes diagnosis more difficult and subjective, and the neurological features are neurocognitive symptoms. Consequently, data on the neurological manifestations in infants are scarce in the medical literature. Therefore, in this case report, we describe a new sign of coronavirus infection in infants.

Patient concerns

A 6-month-old female with unusual presentation of excessive crying, irritability, and bulging anterior fontanelle, without fever or other manifestations, had a history of COVID-19 infection 3 days ago.

Diagnosis

Benign intracranial hypertension associated with COVID-19 was diagnosed based on the clinical presentation and ruling out other causes by laboratory investigations and radiological imaging.

Interventions

The patient was treated empirically with intravenous antibiotics.

Outcomes

The patient was discharged from the emergency center with an outpatient follow-up. At the time of discharge, she had reassuring vital signs and a normal physical examination. At the follow-up visit after 1 week, no clinical symptoms were reported and the physical examination results were normal.

Lesson

Pediatricians should be vigilant regarding the association between COVID-19 and bulging fontanelles.

Other Information

Published in: Medicine, Case Reports and Study Protocols
License: https://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://journals.lww.com/md-cases/Fulltext/2022/10000/Bulging_fontanelle_as_a_sign_of_COVID_19_infection.8.aspx