4th Pediatric Infectious Diseases Conference
 
 
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Neurological problems
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Specialist Answers
Question
A 7 year old female came with fever since 5 days, vomiting 2 days and altered sensorium. She had received syp augmentin for tonsillitis. Now neck stiff+. CSF showed sugar 39, prot 108 with 10 cells 40% neutro and 60 % lympho. csf Ig G and M for TB negative and ADA levels normal. Is it pyogenic or TBM? CT shows gliotic area in it temporal lobe with suitable hydroceph in contrast studies.
Answer
Rule out partially treated pyogenic meningitis, TBM and viral encephalitis. A repeat CSF after 48 hours of intravenous antibiotics may be useful. If sugar improves on CSF, it may suggest pyogenic meningitis. Also get an EEG done to rule out herpes encephalitis. CSf for herpes ELISA, culture and TB PCR may be useful.
 
 
 
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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
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