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What Does This Chest X-ray And ECG Report Of An Infant Indicate?

Posted on Fri, 19 Dec 2014

Question: Recently adopted 10 month baby girl
She had bcg reaction with unresolved cyst more than 2 month which was surgically drained.
Since the drained fluid was mildly positive for tb rifamicin and Isoniazid was prescribed for 3 month
At the time of finishing the course of antibiotic we adopted her
Chest xray, echocardiography, neuro sonography and abdomen ultrasound is normal
Blood work hb 10.5' CBC 11500, lymphocytes 64% and esr 15
Is this abnormal?
She is 6.5 kg
Very active, no fever, occasionally coughing, standing with support
Now I wanted to know weather she is affected by tuberculosis
If yes, How the prognosis will be ?

Answered by Dr. Deepak Kishore Kaltari (4 hours later)

Brief Answer:
Baby blood report is normal

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Ms XXXXXXX

Few babies could experience exaggerated immune reaction to BCG vaccination causing the collection of purulent material. This leads on to cyst formation due to intense immune reaction.
As the BCG is live attenuated vaccine the fluid will be positive for testing of TB. Persistent collection is indication to start anti tubercular drugs. As the baby has adequately received double drugs for 3 months she is unlikely to have active Tuberculosis. Her blood reports are also within normal limits and there is no cause for concern.

Wishing you and your family a very happy and healthy life.

Take care

Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Kishore Kaltari (13 hours later)

Today we chked wbc is 18500 and esr 19
Im really scarred previous blood result was taken week back
She is having mild temperature
On day Before taking blood test she was given vaccination e

Answered by Dr. Deepak Kishore Kaltari (3 hours later)

Brief Answer:
Additional information required

Detailed Answer:
Hi

Dear Ms XXXXXXX

As you have not mentioned which vaccine was given , I assume it to be measles vaccine as baby is 10 months old.
Post measles vaccination could cause fever and mild rash . So white blood cell count is likely to be elevated due to that.
It would be very helpful if you could provide me with following additional information

1. Is the baby feeding well ?
2. Is there excessive crying while passing Urine ?
3. Any respiratory symptoms like cough or cold ?
4. Is urine clear ?

Awaiting your response

Take care
Best regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Kishore Kaltari (28 minutes later)

Mild cough
Mild fever in the afternoon now she is fine
Activity is fine
No excessive crying

Vaccine was rotavirus and hib
Any abnormality in xra
y

Answered by Dr. Deepak Kishore Kaltari (7 hours later)

Brief Answer:
Chest X ray grossly normal

Detailed Answer:
Dear Ms XXXXXXX

Chest X ray looks grossly fine . HiB vaccine could cause mild fever. Raised counts is likely to be due to cough. As her activity is fine there is no cause for concern.

If the following criteria are fulfilled there is no cause for concern

1. Accepting feeds well
2. Weight gain adequate
3. Activity normal

Take care

Best regards
Dr Deepak

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Yogesh D