Febrile seizure (pediatrics) Quiz: Ace Your Exams
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A 2-month-old girl is brought to the emergency department by her parent following a witnessed generalized tonic-clonic seizure at home. The parent reports the seizure lasted about 10 minutes and did not recur. The child has been ill with a cough and congestion for the past day. The infant has been eating and drinking normally but has been more irritable than usual. The patient was born full-term via vaginal delivery, and the pregnancy and labor were uncomplicated. The infant has no other significant past medical history, and vaccinations are up-to-date. Temperature is 39.0°C (102.2°F), pulse is 100/min, and blood pressure is 105/58 mmHg. The patient is awake and alert and moving all extremities equally. Head and neck exam reveals mild bilateral tympanic membrane bulging and erythema and crusting around the nares. The anterior fontanelle appears full. Cardiopulmonary examination is within normal limits. Point of care blood glucose is 88 mg/dL. Which of the following features of the case is an indication that this patient requires further evaluation for an underlying infectious cause of the seizure?
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