Chonnam Med J.  2010 Aug;46(2):117-120. 10.4068/cmj.2010.46.2.117.

Transient Bulging of the Fontanelle in Infants after a Febrile Illness without Central Nervous System Infection

• Bae SH
• Kim YO
• Kim SJ
• Son YJ
• Woo YJ

• KMID: 1730009
• DOI: http://doi.org/10.4068/cmj.2010.46.2.117

Abstract

Increased intracranial pressure in infants with open cranial sutures can cause bulging of the anterior fontanelle. This condition is referred to as transient bulging of the fontanelle (TBF) if the bulging anterior fontanelle regresses spontaneously and no specific causes, such as central nervous system infection or a space-occupying lesion, can be identified. This is a different form of idiopathic intracranial hypertension that occurs during infancy. We encountered three infants with TBF who presented with irritability and a bulging anterior fontanelle after a febrile illness. There was no evidence of a central nervous system infection or a space-occupying lesion in any of the three infants. All three patients had normal cerebrospinal fluid (CSF) findings; negative blood, urine, and CSF cultures; and normal brain imaging studies. Associated infections were confirmed in two cases (rotaviral enteritis in one patient and exanthema subitum in the other). The bulging anterior fontanelle improved rapidly after lumbar puncture and resolved completely within 5 days. We report these three patients with TBF along with a review of the medical literature.

Keyword

Intracranial hypertension; Infant; Fever

MeSH Terms

Central Nervous System
Central Nervous System Infections
Cranial Fontanelles
Cranial Sutures
Enteritis
Exanthema Subitum
Fever
Humans
Infant
Intracranial Hypertension
Intracranial Pressure
Neuroimaging
Pseudotumor Cerebri
Spinal Puncture

Figure

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  Fig. 1 The photograph shows a tense and bulging anterior fontanelle (patient 1).

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