Fever for 15 days with one episode of convulsion
Author:
Pediatric Oncall
Question
A 1 year old girl born of non consanguineous marriage presented with fever and cough for 15 days. She had an episode of generalized tonic clonic convulsion 1 hour ago with frothing from month and lasted for 5 minutes without any past-ictal drowsiness. Father had history of febrile convulsion in his childhood. On examination, child was febrile, had no neck stiffness, had congested and enlarged tonsils. CNS examination, blood pressure was normal. Other systems were normal. A lumbar puncture done showed clear, colorless fluid with normal sugar and proteins with 178 RBCs/hpf and 2 lymphocytes/hpf.
What is the likely diagnosis?
Expert Opinion :
This child has fever since 14 days with tonsillitis, CSF shows RBCs (non-traumatic trap). Hence the diagnosis would be viral meningitis. Even though there is family history of febrile convulsion, the child has had convulsion after 15 days of fever and CSF is not absolutely normal. Thus, diagnosis of atypical febrile convulsion is unlikely.