Question of the Week

Question :
Posted On : 30 Jul 2020
A 12 yrs old girl having fever for the last 10 days, headache, and vomiting for the last 10 days, she has episodes of headache which results in vomiting. After vomiting headache is relieved. On examination no neck stiffness, kerning negative. No other positive findings. CBC and widal negative.
what could be the cause of the headache followed by vomiting. After that headache is relieved for a while. Can it be the early stage of meningitis?
Expert Answer :
Expert 1: A very important cause of headache that is relieved by vomiting is raised intracranial pressure. Have you done a contrasting head CT? If that is normal, this could be a status migrainosus or subacute non-bacterial meningitis.
Expert 2: Sounds like raised intracranial pressure. One of the causes is meningitis. There are many other causes. I would image the pt with an MRI with contrast. A venogram will help too for benign intracranial pressure.
Answer Discussion :
Bharti Gehlot
3 years ago
Bharat S Rastogi
One possible diagnosis could be either Enteric fever or even Malaria, depending on her home town's endemicity.
Sinusitis could be another differential.
migraine, usually fever not present or not long lasting but could be viral fever associated with migraine. History as well as examination findings too less to fix a diagnosis.

3 years ago
Nung Pertin
what is the answer?
3 years ago
Ambeh Deoline Abeiya
3 years ago

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