Brief Answer:
Normal Ct scan is reassuring. Broad spectrum antibiotherapy , await lab res

Detailed Answer:
Hi and thanks for the query,

It is good and reassuring that the CT scan came back normal. A sample taken for laboratory and culture, with a subsequent antibiogramme to identify the appopriate germ and drug is a perfect idea as was done.

I do think the most important thing at this point in time is appropriate broad spectrum antibiotics and monitoring of the patient. It is a great idea the patient is in an intensive care unit.

It is easier for young persons to get seizures with raised temperatures and altered blood parameters compared to elderly patients. If it is a child, considering that the CT scan was normal, I really do not think you need to worry very much. The most important thing now is temperature control, proper antibiotic therapy and monitoring of his general health status as the laboratory results are being awaited.

Thanks and kind regards as I wish the best of health and a rapid recovery.

Kind regards,

Dr Bain

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Brief Answer:
Blood culture and an electrolyte panel

Detailed Answer:
Hi and thanks for the query

I went through the reports carefully.

I think the results are compartible with an infection from salmonella (typhoid). The antibiotic prescribed is appropriate.

However, I would suggest a blood culture and an antibiogramme . knowing the exact bacterium and required antibiotic sensitive to treat it could be very helpful. It is good a culture of the spinal fluid from the lumbar tap is underway and could help.

I think the latest treatment plan is ok. A blood culture and awaiting results of the spinal fluid culture are ok.

Controlling the child s blood glucose is of utmost importance to be monitors carefully. Doing an electrolyte panel (potassium, sodium, calcium) is also important. Disturbances in these electrolytes could entertain an altered mental status.

Thanks and kind regards

Dr Bain

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Brief Answer:
Patience and caution

Detailed Answer:
Hi and thanks for the query

I understand this can be very disturbing. You however need to be reassured on other hand since the CT scan of the brain that was done is within normal limits. I suggest proper blood glucose control, appropriate blood oxygen monitoring and checking of blood sodium, calcium and magnesium levels that could permit continued or sustained seizures.

The anti seizure therapy instituted in my opinion is fine and, maybe we have to give some time, say a couple of days to cautiously wait and see how the seizures evolve. The opinion of the neurologist and doing an ekectroencephalogram (EEG) should be considered at some point in time.

Kind regards

Dr Bain

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Brief Answer:
Techniques and results depend on level of training and experience, patience

Detailed Answer:
Hi and thanks for the query,

Yes of course results can change from lab to lab with regards to the EEG. Findings can also change depending on the time of the day in which the test is done. However, key abnormalities will rarely be missed with a skilled interpreter. I strongly believe since the seizures have started improving and his regaining consciousness potential quite reassuring, we could be a bit patient.

CT scan and MRI results will be rarely missed under such circumstances. The techniques and generally very standardized. I would rarely think the issue should be at the level of missing key abnormal findings. Poor quality scans do exist, but would be a bit rare these days.

I agree that the quality of staff doing the test and interpreting results do matter. But I don't think this could be the case here, though there's always a possibility. We can just a be a bit patient for a couple of days as the child takes his treatment and is monitored.

Kind regards,

DR Bain

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Brief Answer:
Clinical status promising, normal MRI and spacing of seizures

Detailed Answer:
Hi and thank you for the update,

I have gone through his latest reports carefully as you did upload them. The child is increasingly becoming sensitive to touch from the clinical review and the gaps between the seizures is increasing. I think with these clinical parameters, there is much hope that the health status will get better.

It is good news that the MRI scan is within normal limits. Being in a state with continuous seizures could explain EEG abnormalities. It would be more interesting, and too early to worry so much about this. I think the child simply needs to be monitored clinical carefully and his treatment pursued.

Failure to identify any germ on the culture within two days might imply a sterile culture or germs that grow more slowly, that could require much time to be identified. It is good that an antiviral therapy has been associated, as well as continuing the antibiotics that the child was put on.

I think the treatment protocol the child is on is fine and the clinical course is promising.

Thanks and kind regards as I wish you the best of health.

Dr Bain

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