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A three-and-a-half-month-old infant with diagnosed BM caused by E. coli. Due to the lack of clinical improvement when using triple combination antibiotic therapy (cefotaxime/amikacin/ vancomycin) it was decided to administer a drug directly into the empyema area by anterior fontanelle puncture. The images show the puncture needle end in the transverse and longitudinal planes. Gentamicin was administered into the empyema cavity and approximately 60 ml of pus fluid was drained
