Bulging fontanelle in neonates
Different from grown children, neonates do not have a completely mature skeletal system. There are several areas of the skeleton they will progressively grow harder and stronger, and one of them is the skull. After touching the skull of a neonate, you would find a few gaps with no bone. Instead, they have a soft membrane in between that will slowly become bone as he becomes older. These spaces are called fontanelles, and there are two main fontanelles in your baby: one in the front called anterior fontanelle and it is shaped like a diamond, and one in the back called posterior fontanelle and it is shaped like a triangle. These two spots are extremely important to detect meningitis in a newborn.
These spaces should be kept in line with the skull, but when they start bulging or protruding this is a bulging fontanelle and often appears in meningitis. This is a sign of intracranial pressure, and it is often accompanied with lethargy, irritability, and other worrying symptoms. In these cases, do not delay the diagnosis of your newborn. If you have a doubt about the fontanelles in your newborn, talk to your doctor so he can clearly instruct you and answer to your concerns.
As you can see, meningitis can be a highly variable disease. Even the basic signs and symptoms associated to the nervous system sometimes are not the ones to look for in a given patient. There’s a variation in children, adults, and even immunocompromised patients. Therefore, while it is important be attentive to the symptoms, sometimes you don’t need to have the triad of headaches, vomiting and fever to suspect this disease.
In any case, if you find yourself in doubt about your current medical condition, or if you detect an abnormal behavior in your child or infant, ask your doctor right away. Meningitis has severe complications, including cerebral edema, septic arthritis, and pericardial effusion, and may also result in long-lasting consequences such as deafness, paralysis, intellectual problems, and much more. Thus, an early treatment is your way to go to prevent all of these consequences in yourself and your siblings.
References
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Chin, R. F. M., Neville, B. G. R., & Scott, R. C. (2005). Meningitis is a common cause of convulsive status epilepticus with fever. Archives of disease in childhood, 90(1), 66-69.
Andersen, J., Backer, V., Voldsgaard, P., Skinhøj, P., Wandall, J. H., & Copenhagen Meningitis Study Group. (1997). Acute meningococcal meningitis: analysis of features of the disease according to the age of 255 patients. Journal of Infection, 34(3), 227-235.
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