Recurrent bacterial meningitis in children is potentially life-threatening and induces psychological trauma to the patients through repeated hospitalization. Here we report a case of recurrent meningitis in a one month old baby. The CSF and blood culture grew Salmonella enteritidis. Injection ciprofloxacin and ceftriaxone were given for 3 weeks. Baby became symptomatically better and was afebrile at discharge. Twenty eight days after discharge baby got readmitted with complaints of fever and refusal of feeds. Blood and CSF culture again showed growth of Salmonella enteritidis. Physicians should be educated about the possibility of recurrence which may occur days or even weeks after apparent successful antibiotic treatment.
AimsTo monitor serum sodium levels (in mEq/l) in healthy term/near-term infants in early neonatal period. To identify risk factors for hypernatremic dehydration and possible early interventions.MethodsOnly healthy term/near-term inborn babies were included. They were examined on days four, seven and ten of life. Blood samples were collected on days four and ten of life, serum was separated and stored at −20°C for subsequent analysis for sodium. Serum sodium was compared with weight loss and different risk factors were analysed for association with hypernatremia.Results184 healthy term/near-term neonates were included. Mean serum sodium was 149±6.0 (135–172). Sodium levels were normal (135–145) in 47 (25.5%) neonates; hypernatremia of varying severity was detected in 137 (74.5%). 62 (33.7%) neonates had serum sodium levels between 146 and 150, 62 (33.7%) between 151 and 159, and 13 (7%) had serum sodium ≥160. By day 10 of life sodium levels had normalised in all except one, who was hospitalised on day 5 of life with hypernatremic dehydration. His day 4 serum sodium was subsequently found to be 172. Association of different risk factors with hypernatremia is in the table 1. Signs of dehydration were discernible in only nine patients and all of them had hypernatremia, however, most of the babies didn’t have obvious dehydration signs.ConclusionMild to moderate hypernatremic dehydration is quite common in early neonatal period and adequate breastfeeding is an effective and safe intervention.Abstract G207(P) Table 1Comparison of variables between two groups Hypernatremic neonates Neonates with normal sodium P-value Maternal age 30.1±3.4 28.7±3.9 0.07 Birth wt 3.09±0.46 3.11±0.41 0.77 Symp/asymptomatic 49/88 7/40 0.009 Oliguria 13 0 0.04 Nipple problem 3 0 0.57 Decreased milk production 21 1 0.016 Signs of dehydration 9 0 0.11 Wt loss> 10% 13 2 0.36 Daily wt loss> 2% 47 12 0.28 Caesarean/Normal Delivery 87/50 20/27 0.016 first-born/later-born 50/87 26/21 0.026
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