Diagnostic Dilemma

Irritability in a one and a half years old boy


Author: Pediatric Oncall
Question
A 1½ years old boy presented with fever and cough for 4 days. He had similar complaints 1 month ago for which he was hospitalized and treated with intravenous antibiotics for 7 days. He was admitted for febrile convulsion at the age of 1 year during which lumbar puncture was done which was normal. There was no breathlessness, altered sensorium and convulsion presently. On examination, he was febrile and had tonsillitis. There were no meningeal signs and systemic examination was normal. The resident doctor noticed excessive irritability of the child on rounds. However, the child continued to remain normal during the rest of the time. A central nervous system (CNS) infection was suspected thus.

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