Atypical presentations of meningococcal meningitis include acute cerebellar ataxia,1 psychosis,2 and hydrocephalus.3-10 This last presentation was recognized in the past but has not been reported in the last 30 years.
Report of a Case.—A 6-month-old girl had been well, having had a normal birth and neonatal and developmental history until six weeks prior to admission to Children's Memorial Hospital, Chicago. At that time, she had a febrile illness and completed a full ten-day course of oral penicillin therapy after a throat culture was found to be positive for group A β-hemolytic streptococci. Subsequently, her mother noted that she had trouble swallowing solids, frequently gagged, had a sharp decrease in spontaneous vocalization, and lost the ability to sit without assistance. One week after the last dose of penicillin, she had a brief febrile illness without localizing signs. An examination by her pediatrician was unremarkable, and the illness