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The Pediatric Forum
January 1998

What Bulges Under a Bulging Fontanel?

Arch Pediatr Adolesc Med. 1998;152(1):100-101. doi:

The anterior fontanel is one of evolution's gifts to physicians who care for children. Pathological prominence or "bulging of the fontanel" is supposed to be a sine qua non of acute bacterial meningitis in infants. Review of multiple early and current texts in pediatrics and infectious diseases failed to disclose a satisfactory explanation for the pathophysiology of the bulging fontanel in meningitis. A computed tomographic head scan of an infant who had this sign early in the course of acute bacterial meningitis helped elucidate its pathogenesis.