Question
A 45 days old child admitted with complain of cough, fever of 8 days. On day of admission baby had temperature of 102-104 f, respiratory rate-60-80 per min, heart rate More than 200 per mint. Total WBC -90,000 per cu mm {n-90 percent}, peripheral blood smear shows toxic granules in 30 percent cells, no malignant cell. X ray chest shows right upper lobe consolidation, bilateral diffuse infiltrate. Blood culture- sterile. Linezolid, meropenem, ofloxacin, amikacin started but 2 days after total WBC was 100000, mm, {n-90 percent}, no radiological improvement, Then chloramphenicol and oral azithromycin were added. Three days after that WBC comes down to 79000, mm. Now after 12days of IV antibiotic, WBC is 51000, mm but fever is still persisting 100-102f, Heart rate-130-160 per min, Resp rate 40-50, min.