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Question

A 5 five years old boy, for the last 8 months having sterotyped symptoms of feeling unwell, headache,hallucinations and vomiting. he has documeted history of fever of upto 104F. giving calpol relievs the fever and after fever is relieved ,he is normal in his routine work. He has 10-12episodes in a day and use to occur every 3 days, and then every 3 weeks and such so that he has now 10-15 episodes since Jananuary. There is no consitutional symptoms. No tummy pain, no joint pains. On examination now he has a temp of 104F. Apart from temperature , examination is absoultely normal. His full blood count, LFT, Immunoglobulins are normal. Only worry is the raised CRP of 42. Please help me to arrive at the diagnosis and help this little kid. Waiitng anxiouxly for the reply soon

Answer

Rule out a CNS tumor since he has hallucinations, headache along with fever and vomitting. An LP would also be recommended to rule out chronic infections. Do a CST cryptococcal test also.
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