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Prepared by...
Virat Sirisanthana, M.D. |
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Department of Pediatrics,
Chiang Mai University
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A one-year-old girl came in with
febrile illness for 4 days. On the day of admission she was febrile (body
temp = 41 C) and drowsy. The CBC before admission show : Hb 10.5 mg%,
Hct 33%, WBC 19600 cells/cb.mm. (PMN 80%, L15%, M 4%, B 1%), platelet
adequate. Because of high fever and leukocytosis she was admitted on July
8,1999.
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PE: VS: Temp 41
C, PR 120/min, RR 35/mim
HEENT: WNL Chest + Abdomen : WNL Nervous system: rather drowsy, no stiff neck, no neurological deficit. |
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| Laboratory investigation: | ||
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Lumbar puncture
was done on admission day. The CSF examination revealed: protein 10 mg%
sugar 38 mg% (blood sugar 137 mg%), WBC 4,000/cubic ml. (PMN 75%, Mono 25%). |
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The latex agglutinin test of the CSF for S. pneumoniae, H. influenzae type b was negative. | |
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Gram stain of the CSF smear show Gram-negative coccobacilli. | |
| What is the diagnosis? | ||