Diagnostic Dilemma


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.

How should one investigate for the cause of his hypernatremia?
Answer Discussion :
kshounish pradhan
May be a case of post meningitis sequale in the form of diabetes insipidus,though very rare complication.SIADH is more common in this setting.Will have to check for urine osmolality and symptoms
6 Days ago
Peter Nwachukwu
Begining with the kinda fluid given is it appropriate for age and volume given.
what's the renal function like?
was the child dehydrated on admission?
history of feeding ???POOR feeding

11 Days ago

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