Fever and Shock in a Child: How 'good' is a Good Blood Test?
CASE PRESENTATION A 12-year-old girl presented with a history of intermittent fever (38.3°C to 40°C) for 10 days that was not associated with chills and rigours, and was relieved by antipyretics. She also had nonbilious and nonprojectile vomiting (seven days), shortness of breath (four days) an...
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doaj-c30533fa4d9e45559596aed195481e3e2021-07-02T08:28:03ZengHindawi LimitedCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322005-01-0116530130310.1155/2005/404983Fever and Shock in a Child: How 'good' is a Good Blood Test?Nevin Kollannoor Chinnan0Pragnyadipta Mishra1GD Puri2Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaCASE PRESENTATION A 12-year-old girl presented with a history of intermittent fever (38.3°C to 40°C) for 10 days that was not associated with chills and rigours, and was relieved by antipyretics. She also had nonbilious and nonprojectile vomiting (seven days), shortness of breath (four days) and watery diarrhea (two days). At the beginning of her illness, she was treated with a complete course of oral chloroquine by a general practitioner. In the pediatric emergency room, she presented with a heart rate of 136 beats/min, a respiratory rate of 56 breaths/min, a temperature of 37.8°C, a blood pressure of 60/30 mmHg and a capillary filling time of 5 s to 6 s. Shock resuscitation measures were initiated with intravenous normal saline (20 mL/kg bolus) and dopamine 5 µg/kg/min. She developed ventricular fibrillation, which was cardioverted. After cardiac arrest, she was intubated and transferred to the intensive care unit. Two hours later, she started bleeding from the nasogastric tube and endotracheal tube. A chest radiograph revealed bilateral lung opacities suggestive of intraparenchymal bleeding. The other significant clinical findings included icterus, cervical and inguinal lymphadenopathy, soft tender hepatomegaly, moderate splenomegaly and an absence of focal neurological deficits and meningeal signs.http://dx.doi.org/10.1155/2005/404983 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nevin Kollannoor Chinnan Pragnyadipta Mishra GD Puri |
spellingShingle |
Nevin Kollannoor Chinnan Pragnyadipta Mishra GD Puri Fever and Shock in a Child: How 'good' is a Good Blood Test? Canadian Journal of Infectious Diseases and Medical Microbiology |
author_facet |
Nevin Kollannoor Chinnan Pragnyadipta Mishra GD Puri |
author_sort |
Nevin Kollannoor Chinnan |
title |
Fever and Shock in a Child: How 'good' is a Good Blood Test? |
title_short |
Fever and Shock in a Child: How 'good' is a Good Blood Test? |
title_full |
Fever and Shock in a Child: How 'good' is a Good Blood Test? |
title_fullStr |
Fever and Shock in a Child: How 'good' is a Good Blood Test? |
title_full_unstemmed |
Fever and Shock in a Child: How 'good' is a Good Blood Test? |
title_sort |
fever and shock in a child: how 'good' is a good blood test? |
publisher |
Hindawi Limited |
series |
Canadian Journal of Infectious Diseases and Medical Microbiology |
issn |
1712-9532 |
publishDate |
2005-01-01 |
description |
CASE PRESENTATION A 12-year-old girl presented with a history of intermittent fever (38.3°C to 40°C) for 10 days that was not associated with chills and rigours, and was relieved by antipyretics. She also had nonbilious and nonprojectile vomiting (seven days), shortness of breath (four days) and watery diarrhea (two days). At the beginning of her illness, she was treated with a complete course of oral chloroquine by a general practitioner. In the pediatric emergency room, she presented with a heart rate of 136 beats/min, a respiratory rate of 56 breaths/min, a temperature of 37.8°C, a blood pressure of 60/30 mmHg and a capillary filling time of 5 s to 6 s. Shock resuscitation measures were initiated with intravenous normal saline (20 mL/kg bolus) and dopamine 5 µg/kg/min. She developed ventricular fibrillation, which was cardioverted. After cardiac arrest, she was intubated and transferred to the intensive care unit. Two hours later, she started bleeding from the nasogastric tube and endotracheal tube. A chest radiograph revealed bilateral lung opacities suggestive of intraparenchymal bleeding. The other significant clinical findings included icterus, cervical and inguinal lymphadenopathy, soft tender hepatomegaly, moderate splenomegaly and an absence of focal neurological deficits and meningeal signs. |
url |
http://dx.doi.org/10.1155/2005/404983 |
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