In a febrile 2-month-old with poor feeding and lethargy, which diagnosis should be suspected?

• A. Dehydration
• B. Meningitis
• C. Gastroenteritis
• D. Otitis media

Answer: (B)

In a 2-month-old with fever plus poor feeding and lethargy, meningitis must be considered because young infants often show nonspecific signs of serious illness rather than clear meningitis-specific symptoms. The brain infection can progress quickly in this age, and fever with lethargy or poor feeding is the combination that raises the highest concern for a central nervous system infection. The safest, most effective approach is a rapid sepsis workup and prompt treatment: obtain blood, urine, and likely CSF via lumbar puncture, and start empiric IV antibiotics after cultures are drawn. While dehydration or other common infections can cause some similar symptoms, they do not carry the same immediate risk of rapid deterioration as meningitis in a young infant, making meningitis the most probable and urgent diagnosis to address.