Dear Gail, One night on-call I had seen a female child (7 months old) with bulging fontanele (260 mmH2O CSF pressure under sedation) with history of irritability and vomiting following DTP (cellular) dose presenting to the Peds ER. The mother noted the bulging and search for medical assistance. By the following morning, without bulging fontanel, and discharged the third day without other problems. CSF and blood examination and cultures where negative. We searched Medline and found other reports from DTP and bulging fontanel, all with good evolution, without important CNS compromise. Maybe your patient had pseudotumor cerebri. More than 80% of cases are idiophatic and with a good course. Sincerely, Javier Santisteban-Ponce, MD Pediatrician Lima, Peru