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Trevon is an 18-month-old with a 3-day history of upper-respiratory-type symptoms that have progressively worsened over the last 8 hours. Mom states...

HPI: Trevon is an 18-month-old with a 3-day history of upper-respiratory-type symptoms that have progressively worsened over the last 8 hours. Mom states he spiked a fever to 103.2°F this morning and he has become increasingly fussy. He vomited after drinking a cup of juice this afternoon and has refused PO fluids since then.

PE: VS: Temp: 102.5°F;

HEENT: Marked irritability with inconsolable crying, and he cries louder with pupil examination and fights head and neck assessment

ABD: negative abdominal exam

NEURO: You are unable to elicit Kernig's or Brudzinski's signs due to patient noncompliance.

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