Steroid Resistant And Steroid Dependent Nephrotic Syndromes

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Can you give me the most accepted and result wise best regimen for steroid resistant and steroid dependent nephrotic syndromes?... 2). how many times does a CSF culture return positive for fungal meningitis? Can't antifungal be started empirically if patient fails to respond to usual antibiotics and the sensorium continues to deteriorate?... 3) Is it contra-indicated to use steroids and mannitol if NCCT skull shows cerebral parenchymal bleed and a child has features of raised intra cranial tension? what possible remedies for it if not the above two? Thanks for the help PEDIATRICIAN ON CALL !!
Answer
Read the article on STEROID RESISTANT NEPHROTIC SYNDROME on www.pediatriconcall.com or from the link given below: http://www.pediatriconcall.com/fordoctor/DiseasesandCondition/ PEDIATRIC_NEPHROLOGY/PEDIATRIC_NEPHROLOGY.asp In a study from Illinois, it was found that from 1,225 samples of CSF which were cultured for both bacteria and fungi. Of 1,225 samples of CSF reviewed, 12 tested positive for fungi, either by bacterial culture, fungal culture, or the cryptococcal antigen test. (Ref: J Clin Microbiol. 2004 January; 42(1): 236?238. ) Antifungals cannot be started empirically in a child with meingitis unless fungal infection has been proved as the incidence of fungal meningitis is low and treatment consists of amphotericin B with/without flucytosine for a prolonged period of time. For raised ICP due to intracranial bleed, hyperventilation may be required. Mannitol may be used for further control. There is no role of steroids. Back to All Questions

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