Brief Answer:
Let the doctors do the Lumbar puncture. If reports are fine to try without antibiotics

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query carefully and understand your concerns. It seems that the child had developed a pneumonic patch in the lungs as a result of a bacterial infection (sepsis) and was therefore treated with antibiotics.

There was a decreasing trend in CRP and that indicates that the infection was getting controlled. However, this does not explain the sudden jump in CRP and counts today. It could be due to thrombophlebitis or inflammation resulting from the IV cannula. If the child is otherwise fine and active I would have perhaps tried to get the child off IV antibiotics (evidently after elimination of the IV cannula) and see if things seem to be going fine.

Possibly things would go fine if this is done. Oral antibiotics may be given based on the discretion of the doctor. The treating physician can decide based on the factors he has in his consideration. Feel free to discuss the options with him.

Let me know if I could help further.

Regards

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Brief Answer:
A trial of stopping antibiotics should be given.

Detailed Answer:
Thanks for writing back. In the present circumstance if the child is otherwise active and feeding well my suggestion would be stop all antibiotics and to observe him for a couple of days. If he remains fine, he can be discharged directly thereafter. Let me mention that in case of a neonate (baby less than 1 month of age) a blood count of upto 25000 is normal and so I am not concerned about the CBC. The CRP had also shown a downtrend and that has been reassuring. It is just the sudden jump in CRP that was the cause of concern. But the rise in CRP could also be due to channellopathy (IV cannula related inflammation) and therefore I would insist on removing the IV channel and placing him on observation.

Antibiotics kill bacteria but you would be amazed to know that our body has more number of bacteria than it has our own cells. This is normal and having bacteria does not essentially mean that they are harmful. It is just when they get out of hand that they need to be controlled. The highest level of antibiotics have already been tried in the case of your child. Therefore it is possible that in the present scenario bacteria are no longer the offending agent.

The infection cannot continue like that. The situation would either improve or worsen. Placing the child off antibiotics and on observation would clearly point the direction and further interventions, if any, can be planned accordingly. I doubt if there would be any worsening and I am under the impression that the child has possibly already recovered. Its just a wait before the same can be confirmed.

Regards

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Brief Answer:
CSF cell type cell count report needed

Detailed Answer:
Thanks for writing back. The CRP is raised. The protein level in CSF is slightly raised. I would need the CSF cell count and cell type report to correlate if that is a cause for concern.

The ultrasound shows signs of cystitis or bladder infection. In other words, urinary tract infection seems to be the cause of the problems. The antibiotics are proper and the direction of treatment is correct. I would insist you to continue in the ongoing direction.

Since the baby is overall active and fine you need not worry.

Regards

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