JOE'S ANSWERS IN CAPS...
Quoting Abdul Nasir <[log in to unmask]>:
> Hi simnte
> i wanted to tell you one interesting story ..it was 10;00 pm when we
> got a feverish 39 C child of 4 years in our ER , the pediatrician
> called and attended him she ordered for WBC which was 5.5 , she gave
> him naalgsics and augmentine and discharged after fever came down....
> By 4;00 AM the child had been brought dead to ER with full marks of
> petechial hemmorahge which pathognomonic of Meningococcemia...
> It was a big issua that how could a doctor expecting meningococemia
> in a child with fever !!!
> In fact till now i couldnt find an answer inspite that our hospital
> did CME regarding that case and said that onlt around 5% of febrile
> children will go into Meningococemia, and this is very rarely to be
> expcted to appear!
IN FACT ABDUL, THE INCIDENCE IS MORE LIKE 1/2000!! THAT IS IN KIDS
3MO-3 YEARS WELL LOOKING FEVER NO SOURCE...
> Nowadays, i used to either admit or do at least CBC for any febrile
> child even without any bad signs...
A CBC WILL NOT HELP YOU DECIDE WHO SHOULD/SHOULD NOT GET AN LP...IN
FACT-AS YOUR CASE PROVES IT-A COUPLE OF RECENT STUDIES HAVE ACTUALLY
SHOWN THAT THE LR OF MENINGITIS IS HIGHER IF A KID IS LEUKOPENIC/NORMAL
WBC THEN IF HE/SHE HAS LEUKOCYTOSIS...
i still feel hezitated to
> discharge him , scared will get him back as DEAD .
DEFINITELY HAVE BEEN IN YOUR SITUATION...
> Any one can help me by one guidline or rules for that thing?
> For more information, send mail to [log in to unmask] with
> the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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