One hundred and fifty-two patients with purulent meningitis were hospitalized in Childrens' Hospital of Los Angeles. Eleven of 27 patients with fever and their first major motor seizure failed to show any sign of purulent meningitis; all 11 were under 16 months of age. Four of the 11 had a concomitant infection. The presence of purulent meningitis cannot always be excluded in infants with fever whose diagnosis of first major motor seizure is based on clinical examination alone.