Question of the Week

Question :
Posted On : 03 Jan 2019
a 5 year old boy presented with history of headache with fever for last 2-3 days ,was prescribed antipyretics and decongesents and asked to report after 3 days .After three days the child had convergent squint with headache.There were no other symptoms of vomiting or fever .CT scan was sought which showed a communicating hydrocephalus with minimal basal exudates and mild periventricular ooze.There is no history of fever or headache or vomiting or loss of appetite or weight loss.There is no history of contact with tuberculosis.Fundus revealed mild pappiloedema.ESRwas 8 mm and CXR was normal.what d, d should be kept in mind looking the above picture.Should LP be done to rule out TBM.
Expert Answer :
Difficult to answer such a significant hist without seeing pt. Yes LP is a must. Send for TB culture too. What does Xray chest show. My first diff would be tbm but seeing the scan would be most imp. Rule out other rarer causes to cns exudates. LP should help a lot

Dr Anaita Hegde
Consultant Pediatric Neurologist
Jaslok Hospital, Mumbai
Answer Discussion :
arej saad
2 years ago
shashidhara Babu
do ala
2 years ago
Asma Yaqub
TBM. should be confirmed by LP followd by gene expert
2 years ago
A ventriculo peritoneal shunt should be inserted and CSF collected for examination for TB
2 years ago
shahid iqbal
brain abcess?
2 years ago

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