Posted On :
29 Aug 2016
thai girl, 8 yrs old, underlying disease benign tumor at sacral area s, p remove 2 yr. after that she had neurogenic bladder, constipation and lower leg atrophy today she had problem anemia and fever day 3 PE: v, s BT 38.5 PR 100, min BW 18 kg, Ht. 125 cm. good conscious mod. pale , no jaundice no dyspnea, lung: no crep , lower limb: no pitting edema Lab CBC: Hct 18 MCV 80 WBC 13800 N83L17 Plt 250000, UA: single cath : wbc More than 100 rbc 3-5 epit 0-1, alb3plus, U, C: E.coli {ESBL} sense tienam, sulperazone other resistant , BUN, Cr 150, 12.4 E`lyte Na 129 K 4 CL 95 HCO3 18, Ca 8.1 Po4 =3 first treatment : Cef-34 days she still fever and u, c came back step to tienam {correct by GFR =4.6} and other treatment : FBC 13 , folic 11, vit D3 11, sodamint 23, caco3{ 1 g} 12, epo 50 U, kg 2 day, wk , I advice for long term renal replacement therapy and go to nephrologist but her mother deny, what i do for her more last treatment because I stay in district hospitalsorry about my english not well thanks
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