Diagnostic Dilemma


Author: Pediatric Oncall
A 2½ months old boy born of non-consanguineous marriage presented with fever and staring look. He was admitted in a hospital and CSF was suggestive of pyomeningitis. He was treated with IV antibiotics. However on 7th day of illness was found to have hypernatremia (serum sodium = 184 mEq/L). He was given hypernatremic dehydration correction following which his sodium decreased to 159 mEq/L in next 3 days.

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