Perform CT scan. Do not delay treatment to undertake CT scan.

  • Clinically stabilise the child before CT scanning.
  • Consult a paediatric intensivist, anaesthetist or intensivist.

Ongoing treatment:

  • Full-volume maintenance fluids: enteral feeds if tolerated or isotonic IV fluids e.g. 0.9% Saline or 0.9% Saline with 5% Glucose
  • Do not restrict fluids unless there is evidence of increased anti-diuretic hormone secretion or RICP
  • Monitor fluid administration, urine output, electrolytes and blood glucose
  • See Meningitis Research Foundation (2018) Meningococcal disease algorithm to treat seizures.

Monitor closely for signs of raised ICP, shock and repeated review:

  • Go to Meningococcal disease algorithm if signs are found and consult a paediatric intensivist, anaesthetist, or intensivist.
  • Perform delayed LP if no longer contraindicated.
  • If LP contraindicated, perform delayed LP when no longer contraindications.

Has a specific pathogen been identified?

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