4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
TO, Respected sir/madam I had a patient aged 12 years with c/o fever 1 month back associated with vomiting for which he took treatment with local R.M.P. and some Ayurveda drugs, O/E typical cerebellar signs fundus - early papiledema, C.T.Brain - communicating hydrocephalus. L.P. CSF..CELLS 5cells/c.mm all lymphocytes, CSF biochemical analysis...Sugar 45mg% proteins 109mg% with h/o, CT findings, CSF biochemistry, Anti-tuberculous Treatment started, thinking TBM (late) Any ALTERNATE (D/D) DIAGNOSIS CONSIDER regarding this patient?
Answer
One should rule out a benign raised intracranial pressure as CSF picture shows only 5 cells.
Since the CSF sugar is low, one can also rule out a partially treated pyogenic meningitis. Other causes of chronic meningitis apart from TBM such as cryptococcal meningitis, fungal infection, brucella, nocardia also have to be kept in mind.
The child is not behaving like a typical TBM.
 
 
 
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