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Has fever for the past 3 days. Evening feels shivering. Anti HIV I & II Antibodies spot and CT scan all done. Guide?

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Posted on Mon, 30 Sep 2013
Question: My kid had fever for the past 3 days. Fever was intermittent. On 3rd day evening she was shivering similar to fits.
When we took her to hospital and got her admitted. They treated her for fits first and now they are treating for fever which seems to be intermittent even now.

Doctor told that there is a water deposit in the brain and that it became a little solid. He told that after 4 days of stay in ICU they will start treatment for the water deposit in brain.

The tests performed are:
1. Anti HIV I & II Antibodies spot
2. C reactive protein test
3. Cerebrospinal fluid
4. CT Brain
5. Dont remember the test name but CSF Protein/Sugar - 83/12 & Cells = 2000 are the critical values which say that there is a critical issue is what doctor has told us.

I have attached all those reports and request you help in assessing the gravity of the situation. Please help.
doctor
Answered by Dr. Irshad H Naqvi (20 hours later)
Brief Answer:
Pyogenic Meningitis is the probable cause.

Detailed Answer:
Hi,

Investigation report reveal CRP positive, Neutrophilia and polymorph dominant CSF with 2000cell/cubic mm. The reports in the back ground of fever and convusion indicate that the child is suffering with Meningitis probably pyogenic (bacterial). It is a little serious condition to deal with.

Strict supervision at NICU along with relevant antibiotic, anticonvulsant and other required treatment of septic meningitis will help the child to come out of the this difficult situation. The key is to start treatment early. I choose broad spectrum intravenous antibiotic for better results. I hope your doctor's have performed a culture study on the CSF sample and blood sample. Culture reports can then guide your treating doctor to choose the right antibiotic.

Prognosis (outcome from the disease) is little difficult to explain because all depends upon the status of the child and disease. With early treatment, the outcome is better.

Hope the query is answered. Feel free to write back if you need further assistance.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Irshad H Naqvi (2 days later)
I was told that the name of the disease is Haemophilus Influenzae. Attached is the report of the additional tests performed. Please advice on the criticality and next course of action to be taken from our end. She is still in ICU.
doctor
Answered by Dr. Irshad H Naqvi (2 days later)
Brief Answer:
Haemo Influen is exact bacteria detected in CSF.

Detailed Answer:
Hemophilus Influenzae is the name of bacteria causing Pyogenic Meningitis
(grown in the CSF culture).
CSF Culture report may also be the pointing the exact antibiotic for which the bacteria is sensitive. That particular antibiotic should be used in full doses to eradicate the bacteria along with other relevant supportive treatment.

NICU strict supervision and treatment modification as is when required is a must.

Septic meningitis in such age group is quite poor in outcome and it depends upon the time we start controlling the meningitis

Hope for the best.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Irshad H Naqvi

Pediatrician

Practicing since :1989

Answered : 1194 Questions

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Has fever for the past 3 days. Evening feels shivering. Anti HIV I & II Antibodies spot and CT scan all done. Guide?

Brief Answer:
Pyogenic Meningitis is the probable cause.

Detailed Answer:
Hi,

Investigation report reveal CRP positive, Neutrophilia and polymorph dominant CSF with 2000cell/cubic mm. The reports in the back ground of fever and convusion indicate that the child is suffering with Meningitis probably pyogenic (bacterial). It is a little serious condition to deal with.

Strict supervision at NICU along with relevant antibiotic, anticonvulsant and other required treatment of septic meningitis will help the child to come out of the this difficult situation. The key is to start treatment early. I choose broad spectrum intravenous antibiotic for better results. I hope your doctor's have performed a culture study on the CSF sample and blood sample. Culture reports can then guide your treating doctor to choose the right antibiotic.

Prognosis (outcome from the disease) is little difficult to explain because all depends upon the status of the child and disease. With early treatment, the outcome is better.

Hope the query is answered. Feel free to write back if you need further assistance.

Regards