Septicemia

Author: Hariom Rawat

Question
A 45 days old child admitted with complain of cough, fever of 8 days. On day of admission baby had temperature of 102-104 f, respiratory rate-60-80 per min, heart rate More than 200 per mint. Total WBC -90,000 per cu mm {n-90 percent}, peripheral blood smear shows toxic granules in 30 percent cells, no malignant cell. X ray chest shows right upper lobe consolidation, bilateral diffuse infiltrate. Blood culture- sterile. Linezolid, meropenem, ofloxacin, Amikacin started but 2 days after total WBC was 100000, mm, {n-90 percent}, no radiological improvement, Then Chloramphenicol and oral Azithromycin were added. Three days after that WBC comes down to 79000, mm. Now after 12days of IV antibiotic, WBC is 51000, mm but fever is still persisting 100-102f, Heart rate-130-160 per min, Resp rate 40-50, min.

A 45 days old child admitted with complain of cough, fever of 8 days. On day of admission baby had temperature of 102-104 f, respiratory rate-60-80 per min, heart rate More than 200 per mint. Total WBC -90,000 per cu mm {n-90 percent}, peripheral blood smear shows toxic granules in 30 percent cells, no malignant cell. X ray chest shows right upper lobe consolidation, bilateral diffuse infiltrate. Blood culture- sterile. Linezolid, meropenem, ofloxacin, <a class='interlink' href='/drugs/antimicrobial-aminoglycosides/amikacin/15/251'>Amikacin</a> started but 2 days after total WBC was 100000, mm, {n-90 percent}, no radiological improvement, Then <a class='interlink' href='/drugs/antimicrobial-others/chloramphenicol/29/399'>Chloramphenicol</a> and oral <a class='interlink' href='/drugs/antimicrobial-macrolides/azithromycin/28/300'>Azithromycin</a> were added. Three days after that WBC comes down to 79000, mm. Now after 12days of IV antibiotic, WBC is 51000, mm but fever is still persisting 100-102f, Heart rate-130-160 per min, Resp rate 40-50, min. <br></table>

What would be further management_?

Answer Discussion :

suryanarayana regidi

human immune deficency virus

15 years ago

SANTOSH RAO

as the child is improving with azithromycin we may think it as atypical pneumonia and fever which is persistent may be canula induced or due to drugs so stop all i.v. antiboiotics and continue oral azithromycin for 2 more days.

15 years ago

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Septicemia

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