Transient bulging fontanelle following rotavirus vaccination: A case report

Transient bulging fontanelle is a self-limiting clinical condition characterized by a bulging fontanelle with or without fever, which resolves without medical intervention. It is a relatively uncommon adverse event following immunization. We report a case of an 11 week old, otherwise healthy male infant who presented with a bulging, nontense anterior fontanelle without fever, which developed 11 hours after receiving rotavirus vaccine. Transfontanelle ultrasound scan findings were essentially normal. Two days later, the bulging anterior fontanelle resolved spontaneously. The child had normal neurological development and achieved corresponding developmental milestones over the subsequent eight months of follow-up. This case report highlights the importance of immunization history in the otherwise healthy infant who presents with bulging fontanelle. We recommend that in an otherwise well recently vaccinated infant that presents with bulging anterior fontanelle, lumbar puncture should be deferred while the infant is closely monitored.