Question of the Week

Question

Question :

Posted On : 17 Dec 2023

In an unconscious child who has had a fever with convulsion and is suspected to have encephalitis or meningitis How CSF be done when the facility of fundus examination is not available?

Expert Answer :

Answer Discussion :

A

anulika chiemela

0

Treat accordingly to Abcd

1 year ago

D

Dr Mulazim H. Khara.

0

Either CT scan brain with and without contrast be done..and/or
Two mannitol doses, followed by CSF R/E,.

1 year ago

K

Kholofelo Maphoto

1

1. ABCD, Age is NB - those less than 18 months with an open anterior fontanelle we can do an LP. Those above 18 months whose AF is closed. Do CT Brain, then do a LP if CT Brain is normal with no signs of raised intracranial pressure.

1 year ago

M

Murad Ali Khan

0

treat according to ABCD, do CT scan brain and do LP after stabilization

1 year ago

D

Dr Ola

0

Clinical diagnosis is enough

1 year ago

Answer 1

CSF examination should be deferred and the child treated with antibiotics if unstable. Fundoscopy, a skill that can be achieved with practice needs a pocket fundoscope and can be done in undilated pupils. Remember that papilledema can take up to 24 hrs to develop so a normal fundus does not guarantee against raised ICP.

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