CT scan indicated
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?
Next Next