Upon my arrival this morning, the Cuban pediatrician asked me to consult on one of her patients, Manuel. The two month-old presented last evening with fever for several weeks and a recent onset of “seizure”. He was born at home and the parents delayed treatment hoping folk remedies would be of benefit. 

On exam, there were signs of infection and increased pressure of the brain (the sutures were split, fontanel was bulging and he was extremely stiff). He likely developed meningitis weeks ago and the infection caused damage to the lining of his brain. Now he is unable to reabsorb his spinal fluid and has increasing water-on-the-brain (hydrocephalus). We do not have the resources to do surgery and will have to watch and wait.

Manuel on the day of admission


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