04/24/2026
A previously healthy, unimmunized 4-year-old girl presents to the ED with sudden stiffness after a few days of fever, refusal to eat, and decreased speech. She is now afebrile but has high blood pressure, a fast heart rate, limited neck range, and generalized stiffening of her body. A recent minor lip injury that occurred shortly before onset of symptoms is still present. Read this Pediatrics in Review case report to learn how the final diagnosis was made. https://bit.ly/3PQ2ELw