Following a routine immunisation a 9 month old child developed vomiting and drowsiness. On examination there was bulging of anterior fontanelle. Fundoscopy revealed papilledema. The child developed cranial nerve palsies within a few hours. Inspite of all these findings the child was afebrile with clear chest. What is the MOST probable diagnosis?
Meningitis
Sagittal sinus thrombosis
Vit A toxicity
Astrocytoma
The condition described here is pseudotumor cerebri. Along with the vaccination the child may have received a bolus dose of Vit A which might have precipitated the toxicity. In meningitis the child is usually febrile. In astrocytoma the progression occurs gradually. Ref: Nelson, Edition 17, Page - 180.