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An Infant with Fever, Raised Inflammatory Makers and No Apparent Focus for Fever
Kollannoor B, Roberts M, Abdelaziz M
Department of Pediatrics, St Helens and Knowsley NHS Teaching Hospitals.
Address for Correspondence: Dr Maysara Abdelaziz, Consultant Paediatrician, St Helens & Knowsley NHS trust, Warrington Road, Prescot, Liverpool L35 5DR, UK. Email: Maysara.Aziz@sthk.nhs.uk
Clinical Problem:
A 4 month old male infant presented with fever for 4 days. He had no localizing signs on examination. He was irritable and suspected to have meningitis. Investigations showed white blood cells 28,100/cumm (neutrophils 21,500/cumm), platelets 554000/cumm and CRP 312mg/dl. Chest X-ray was normal and urine showed 25 pus cells/hpf but urine culture did not grow any organism. Cerebrospinal fluid (CSF) showed 8 cells/cumm, 1 red blood cell. CSF cultures were negative. Abdominal ultrasound (USG) and CT brain was normal. He was treated with intravenous antibiotics cefotaxime, amoxicillin and acyclovir. After 2 days of admission, he had a swollen ankle and slightly red lips. X-ray of the ankle was normal. Radioisotope bone scan showed no osteomyelitis. CRP was 212 mg/dl after 7 days of antibiotic treatment. Echocardiogram was done on day 8 which was normal. He remained irritable throughout this period.
What is the diagnosis?
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T
Tuberculous Pleural Effusion- Residual Pleural Thickening
Lavina Desai*, Ira Shah**
A 7 year old girl presented with fever for one month. Father had been treated for pulmonary tuberculosis (TB) 6 months ago. She was detected to have right sided pleural effusion with pneumonia on ches....
M
Musculoskeletal Cysticercosis
Lavina Desai*, Ira Shah**
A 23 year old female was referred to us in April 2016 with right shoulder swelling for 3 months. In January 2015 she had fever and right axillary lymphadenopathy and was diagnosed to have right forear....
P
Persistent Pseudomonas Aeruginosa Infection in a child with Cystic Fibrosis – How to manage?
Lavina Desai*, Ira Shah**
A 6 month old girl was diagnosed to have cystic fibrosis (CF) in 2009 in view of recurrent respiratory tract infections and diarrhea with malnutrition. Sweat chloride conductivity test was positive (7....
I
Is it Gaucher’s Disease or Niemann-Pick’s disease?
Lavina Desai*, Ira Shah**
A three and a half-year-old girl, currently bedridden, presented in 2013 with progressive loss of milestones from two years of age. On examination she showed poor oral hygiene, oral thrush over the ha....
R
Right Lung Opacification – What is the diagnosis?
Ilechukwu GC, Kollannoor B, Abdulaziz M.
A previously well, 7 week old baby presented to the paediatrics accident and emergency unit with a history of cough and fast breathing of one week duration associated with reduced oral intake of <50%.....
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Disease A-Z
Health Topics
Alternative Medicine
Developmental Pediatrics
General Pediatrics
Genetics
Immunodeficiencies
Infectious Diseases
Laboratory Medicine
Neonatology
Nutrition
Pediatric Cardiology
View all topics
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Circumcision
Anal itching
Anal fissure
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