Meningitis (pediatrics) Quiz: Ace Your Exams
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A 3-week-old girl is brought to the emergency department by her parents due to a 12-hour history of fever, irritability, and decreased feeding. She was born at term via an uncomplicated vaginal delivery and had an unremarkable neonatal course. The patient's 3-year-old sibling recently started daycare. Temperature is 38.3°C (100.9°F), heart rate is 160/min, respiratory rate is 40/min, blood pressure is 76/49 mmHg, and oxygen saturation is 95% on room air. Physical examination reveals a lethargic infant with a normal head circumference and no fullness of the anterior fontanelle. There is no rash, and her neck is supple. Capillary refill is less than 2 seconds. Cardiopulmonary examination is unremarkable, and the abdomen is soft and nontender. Neurologic exam is nonfocal, and she is moving all four extremities. Bloodwork shows increased CRP and prolactin levels. Blood cultures are obtained, and a lumbar puncture is being performed. Which of the following is the best next step in management?
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