for those who ask about spinal tap, I quote- Febrile infants between 1 month and 3 months who are ill-appearing, have an abnormal cry, or have rectal temperature ≥ 38.5° C have a high risk of serious bacterial infection regardless of initial laboratory results. Such infants should be hospitalized and given empiric antibiotic therapy using ceftriaxone or cefotaxime pending the results of blood, urine, and CSF cultures.-MSD manuals
We would like to see more history of MBBS subjects surgery,medicine,gaynec,ENT, opthalmology ,psychiatric ,radiology,skin and dentistry subjects.please upload more and more video sir.and also pediatric history.
it's not a bronchiolitis case, sound like viral infection but as she said, babies at that age could not deal with bacteria, so they wanna try, otherwise, i think that take urine and spinal fluid should be delayed according to result of CBC and CRP or procalcitonin
@@datnguyen-oh8vo I agree..very rare to see bronchiolitis without wheezes, and those babies have a worse resp physical exam compared to this. I saw a case in a developing country and it was a sicker kid, they were exceedingly tachypneic and had retractions just like a pneumo kid. I agree with u, they should have done just a urinalysis and cbc at this point and determine what next after that
They would have heard abnormal pulmonary sounds during the physicals. As I understand, it takes very little for infants and children to develop wheezes or crackles in case of pneumonia following an infection.
Spinal Tap? Is this only due to the fact that meningitis is most likely worst case scenario? I’m not too knowledgeable when it comes to pediatric infants. I agree off the bat with a CBC, UA, and Blood Cultures.
Love the atmosphere, communication, reassurance to parents everything..👍 Short pre natal , natal, post natal hx I think Spinal tap may not be necessary
Yes, and start broad spectrum abx and antiviral first if spinal tap is delayed. Also know when not to tap straight away such as signs of raised ICP, coagulopathy
I can't really see any indication. Baby is not lethargic, not feeding poorly, no shrill cries, fontanelle flat and soft and other reflexes good. Why the spinal tap?
Why check the csf for what I assume is meningitis if it's signs aren't present during the physical (neck/body stiffness, bulging fontanelles, dehydration, etc...)? I would rather just start with urine/blood culture first. Is it just a routine test for infants presenting with a suspected infection?
Will it be not better to wait for a TLC with differential before starting I.V antibiotics. Both lumbar puncture results and white cell count should be available within an hour.Insertion of a urinary catheter to obtain a urine specimen is a bit odd,why not use another method for this.
Catheter specimen urine is a sterile method of collecting urine so as to get back the most accurate results also empirical antibiotics are better than no antibiotics
for those who ask about spinal tap, I quote- Febrile infants between 1 month and 3 months who are ill-appearing, have an abnormal cry, or have rectal temperature ≥ 38.5° C have a high risk of serious bacterial infection regardless of initial laboratory results. Such infants should be hospitalized and given empiric antibiotic therapy using ceftriaxone or cefotaxime pending the results of blood, urine, and CSF cultures.-MSD manuals
We would like to see more history of MBBS subjects surgery,medicine,gaynec,ENT, opthalmology ,psychiatric ,radiology,skin and dentistry subjects.please upload more and more video sir.and also pediatric history.
I don’t know why they want to test the CSF i don’t think the pt has meningitis
It’s more likely bronchiolitis
Any explain ?
it's not a bronchiolitis case, sound like viral infection but as she said, babies at that age could not deal with bacteria, so they wanna try, otherwise, i think that take urine and spinal fluid should be delayed according to result of CBC and CRP or procalcitonin
@@datnguyen-oh8vo I agree..very rare to see bronchiolitis without wheezes, and those babies have a worse resp physical exam compared to this. I saw a case in a developing country and it was a sicker kid, they were exceedingly tachypneic and had retractions just like a pneumo kid. I agree with u, they should have done just a urinalysis and cbc at this point and determine what next after that
They would have heard abnormal pulmonary sounds during the physicals. As I understand, it takes very little for infants and children to develop wheezes or crackles in case of pneumonia following an infection.
great video but i think we can start by a urine Culture + Blood sample only and check up as 1st step then if we don t found the bacteria move to CSF .
Spinal tap for a viral infection? There are no behavioural changes to suggest meningitis.
That seem pretty unnecessarily invasive to me too. The blood and urine culture in this case should be enough
Exactly....no presentation for meningitis
@@r-belaI agree with you why spinal tap though…
Shes 2 weeks old man, you should rule out meningitis in any febrile neonate regardless of symptoms, as they are often asymptomatic.
very nice videos .... 👍👍👍
we would like to see more such ward rounds presentaions.
Spinal Tap? Is this only due to the fact that meningitis is most likely worst case scenario? I’m not too knowledgeable when it comes to pediatric infants. I agree off the bat with a CBC, UA, and Blood Cultures.
Love the atmosphere, communication, reassurance to parents everything..👍
Short pre natal , natal, post natal hx
I think Spinal tap may not be necessary
Presenting a neonate requires, a full perinatal and neonatal history as well.
Doubt: Is spinal tap necessary in this case? Is it recommended for all infants presenting with similar complaints?
Aishwarya Pradhan yes most times it’s to rule meningitis
Yes, and start broad spectrum abx and antiviral first if spinal tap is delayed. Also know when not to tap straight away such as signs of raised ICP, coagulopathy
Helpful thanks!
what is the indication for spinal tap ? i mean in this case ?
I can't really see any indication. Baby is not lethargic, not feeding poorly, no shrill cries, fontanelle flat and soft and other reflexes good. Why the spinal tap?
Why check the csf for what I assume is meningitis if it's signs aren't present during the physical (neck/body stiffness, bulging fontanelles, dehydration, etc...)? I would rather just start with urine/blood culture first. Is it just a routine test for infants presenting with a suspected infection?
short perinatal history
Thank you very much sir.
Very nice.
Will it be not better to wait for a TLC with differential before starting I.V antibiotics. Both lumbar puncture results and white cell count should be available within an hour.Insertion of a urinary catheter to obtain a urine specimen is a bit odd,why not use another method for this.
Catheter specimen urine is a sterile method of collecting urine so as to get back the most accurate results also empirical antibiotics are better than no antibiotics
Is it necessary to give the mom all that information??
nice videos
i love the calm environment, everyone at ease, no p*****ing.
Nice video!!!! We wish to see, more , real cases.
Very succinct