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Case Presentation: BY 13QO320

This document presents a case study of a 4-year-old female patient admitted to the pediatric ward with fever and convulsions. Her symptoms and medical history are described in detail. On examination, she was found to have a fever, tachycardia, and abnormal bloodwork. She was diagnosed with simple febrile seizures. Her treatment included paracetamol, clobazam, ceftriaxone, and tepid sponging. Potential drug interactions and side effects were assessed. Upon discharge, she was prescribed paracetamol syrup, iron syrup, and antibiotics. The attendant was counseled on dietary management, seizure precautions, and fever control.

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Sandeep Chakravarthy
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28 views

Case Presentation: BY 13QO320

This document presents a case study of a 4-year-old female patient admitted to the pediatric ward with fever and convulsions. Her symptoms and medical history are described in detail. On examination, she was found to have a fever, tachycardia, and abnormal bloodwork. She was diagnosed with simple febrile seizures. Her treatment included paracetamol, clobazam, ceftriaxone, and tepid sponging. Potential drug interactions and side effects were assessed. Upon discharge, she was prescribed paracetamol syrup, iron syrup, and antibiotics. The attendant was counseled on dietary management, seizure precautions, and fever control.

Uploaded by

Sandeep Chakravarthy
Copyright
© © All Rights Reserved
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Download as PPTX, PDF, TXT or read online on Scribd
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CASE PRESENTATION

BY
13QO320
DEMOGRAPHIC DETAILS

 NAME : XYZ
 IP No : 596324
 AGE : 4yrs
 SEX : Female
 Ward : Paediatrics
 DOA : 19/12/2018
 DOD : 22/12/2018
 Unit : Unit B
SUBJECTIVE EVIDENCE
 CHIEF COMPLAINTS :-
 Fever : 1 day
 convulsions : in the morning of admission to hospital ,1 episode
 History Of Presenting Illness :-
 Child was apparently asymptomatic till 1 day. Later developed fever
which was insidious in onset progressing to high grade.
 History of 1 episode of convulsion lasting for 10 minutes involving up
rolling of eyeballs, frothing of from mouth, stiffness of all four limbs(tonic),
no involuntary passage of urine or stools, No post ictal drowsiness, No
History of cough, cold, ear discharge.
 Past History : Nothing Significant.
 Family history : No history of epilepsy or seizure disorder in family members.
 Antenatal History : Booked case, had regular AN Scans.
 Birth History : Full term/ NVD/ Institutional delivery/ BCAB/ No Post natal admission.
 Developmental History : Appropriate for age.
 Immunization History : Appropriate for age.

OBJECTIVE EVIDENCE :-
PHYSICAL EXAMINATION :-
• Pulse :- 120/min [80-120bpm]
• BP :- 110/70 mmHg
• RR :- 25/ min [20-30/min]
• Body temp-102 [98.6·f]
SYSTEMIC EXAMINATION :-
 CVS :-
Shape – normal, No precordial bulge,
S1 S2 heard, no murmurs
 RESPIRATORY SYSTEM :-
Shape – normal , trachea appears to be central.
B/L chest movements are symmetrical.
NVBS (+)
 ABDOMINAL EXAMINATION :-
Shape – normal, skin over abdomen normal
no organomegaly , soft and no tenderness.
 CENTRAL NERVOUS SYSTEM :-
Conscious oriented to mother, no sign of meningeal irritation.
 CRANIAL NERVES :-
1 – Not tested
2 – Vision normal
3,4,6 – conjugate eye movements (+) , light reflex (+)
5 – remission over face (+) , corneal and conjunctival reflex (+)
7 – no facial asymmetry
8 – intact
9 , 10 - no pooling of secretions
11 – not tested
12 – no atrophy of tongue
PROVISIONAL DIAGNOSIS

Simple Febrile Seizures


BLOOD HAEMATOLOGICAL EVALUATION:-
• HB- 10.2 (12.1 to 15.1gm/dl)
• RBC- 4.56 (4.2 to 5.4)
• ESR- 35 (3-13mm/hr)
• TOTAL COUNT- 6200 (4000-1100)
• NEUTROPHILS- 70
• LYMPHOCYTES- 28
• EOSINOPHILS- 02
• MONOYTES- 00
• BASOPHILS- 00

ELECTROLYTE PROFILE
• SODIUM- 132 (135-145mEq/L)
• POTASSIUM- 3.9 (4-5.5mEq/L)
• CALCIUM- 5 (4-5.5mEq/L)
• MAGNESIUM- 2 (1-2.5mEq/L)
• CHLORIDE- 99 (96-100mEq/L)
FINAL DIAGNOSIS

SIMPLE FEBRILE SEIZURES


TREATMENT:
DRUGS DAY 1 DAY 2 DAY 3 DAY 4

SYP
PARACETAMOL
125mg/5ml TD    
TAB.CLOBAZAM
10mg BD
   
INJ.CEFTRIAXONE
(350mg IV BD)
   
SYP.TERBUTALINE+
AMBROXOL
BD  
SYP.TONOFERON
BD (1ml)
   
TEPID SPONGING
 
ASSESMENT:-
 Paracetamol (acetaminophen)
It is used to reduce body temperature during fever
Side effects- bloody or black stools , pain in lower back , skin rashes ,hepatotoxicity ,
nephrotoxicity
 Tab frizium (clobazam)
Used as adjunctive therapy in epilepsy. It is also used for short term relief of anxiety
Side effects-amnesia, muscle weakness , serious skin reactions ,hepatic impairment , renal
impairment.
 Injection Ceftriaxone :-
It is a cephalosporin antibiotic and works by fighting bacteria. It used to treat many kinds of
bacterial infections.
Side effects : swelling, redness, pain at site of injection. It may also cause loss of appetite.
 Syrup Kofarest :-
It is used in the treatment of productive cough.
Side effects : increase heart rate, drowsiness, headache, sweating, muscle cramps.
 Tonoferon :-
It is used in iron deficiency.
Side effects : Chest pain, fever, headache, lymph node enlargement.
 Tepid sponging :-
It is done by washing the body with a sponge and luke warm water. It is used for the
reduction of fever.

DRUG INTERACTIONS:-
NO DRUG INTERACTIONS WERE FOUND IN THE TREATMENT
DISCHARGE MEDICATION :-
Syrup Paracetamol 125 mg for 5ml
Syrup Tonoferon 1 ml x 3 months
Syrup Terbutaline+ambroxol- 5 ml
Syrup Ceftriaxone- 4 ml

PLANNING :-
Communication with the doctor :
Kofarest is contraindicated in seizures.
Because terbutaline causes tremors and nervousness
Communication with the patients attender :

 For seizures, Ketogenic diet in which primarily proteins , fats and limited carbohydrate can
be taken like sea foods , meat etc.
 Fruits and vegetables such as citrus fruit ,tomatoes , spinach ,sprouts ,leafy greens ,beans ,
 Iron rich foods should be taken and in case the hb level drops then blood transfusion is
required.
 In case of reoccurrence of seizures try to move furniture or other harmful objects that might
injure the person during the seizure.
 Do not force anything including your fingers into the persons mouth as it may cause injuries
to him or her.
 Loosen tight clothing around persons neck and waist. Do not give anything to eat or drink
until the person is fully awake and alert.
 Tepid sponging in case of rise of temperature.
THANKYOU

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