Thanks for writing to us.
The very fact that your girl had an ear infection
and now during fever she also complains of neck pain
has alerted you towards meningitis
.As your question indicates that you have a good health education,Kindly check for signs of meningeal irritation
A)Sign of Neck Rigidity:Ask your girl to bend her neck to touch her chin to upper anterior chest.If there is meningeal irritation she will not be able to and the neck pain worsens.
B)Kernig's Sign;While the girl is supine and lying down flex her knee and hips.Now try to extend only the knee joint.Inability to extend beyond 135 degrees indicates positive Kernig's sign indicating meningeal involvement.
C)Brudzinski's Sign;In the event of positive neck rigidity test, when you try to flex her neck yourself in an attempt to touch chin to chest,the knee joint and the hip joint also gets flexed.This also indicates meningeal irritation.
D)In addition find out whether there is any difficulty in swallowing of food.weakness of facial nerve
.Inability to walk with eyes closed.Finger nose test.These positive indicate neurological deficits.
As you have mentioned about meningitis ,I have informed you to carry out the above tests to educate you since an MD need not wait for Lumbar Puncture
reports to come to start a higher antibiotics.The ear infection if not fully cured might spread to the meninges and also in some immuno compromised and undernourished may cause Cerebellar Abscess.
Pls take her to a Tertiary Care Unit/TCU to start a better antibiotic .Giving T.Calpol is insufficient First Aid
Get well soon.
Dr Lt Cdr ASN Bhushan.