A 1 year old boy had pericardial effusion. Mantoux test was negative. Pericardial tap showed 2 gm/dl proteins, 91 cells/hpf (15% polymorphs, 85% lymphocytes). The child was started on 4 drug Anti tubercular therapy (ATT) along with oral prednisolone (2 mg/kg/day). Repeat echocardiography at end of 2 months showed trivial pericardial effusion with thickening of pericardium. His steroids were tapered and stopped. However, he developed drug induced hepatitis within 3 weeks of starting ATT. HRZ were stopped and child was started on Ciprofloxacin & Streptomycin and Ethambutol was continued. SGPT normalized after 2 months following which HR were gradually reintroduced and Streptomycin & Ciprofloxacin were stopped. The child was subsequently continued on HRE. At the end of total 5 months of therapy, he has ascitis with pericardial effusion.
A 6 month old boy with congenital moderate ventricular septal defect (VSD) on decongestive measures consisting of frusemide and digoxin presented with irritability, vomiting and oliguria since 2 days. There is no fever, refusal of feeds or lethargy. On examination, he is malnourished (weight = 4kg), with some dehydration, has heart rate of 100/min and a pansystolic murmur at the apex. Other systems are normal.
What is the diagnosis? How to treat?
Read the entire teaching clinical query in the section of “TEACHING FILES” and try the correct answer.
Last month's teaching file: A 4-month-old boy presented with fever, cough, cold since 5 days and breathlessness since 1 day with decreased appetite. Chest X-Ray = Bilateral lower zone pneumonia with minimal pleural effusion and inter fissural effusion on right side. Which is the organism causing the pneumonia?
Note:The appearance of advertisement or product information in the various section in
the website does not constitue an endorsement or approval by Pediatric Oncall of
the quality or value of the said product or of claims made by its manufacturer.
Syrup formulations of antiretrovirals especially zidovudine and nevirapine are in short supply due to decreased production. How to give prophylaxis to the babies to prevent vertical transmission of HIV_?
Pulverise the adult tablet and give
Do not give prophylaxis to the babies
On humanitarian grounds, the production should be maintained
The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.