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Sunday, March 6, 2011

Re: Feedback via the Online Free advice by Dr SK


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Post or paste your query here:Dr. Kondekar,
I have a question about my nephew. I did try to consult with you last year.|
My nephew was admitted to the hospital in Thane c/o cough and fever in 2010 Feb; diagnosed with strep pneumoniae and discharged on augmentin. Three days after the discharge, he was readmitted due to persistent 101-102 F fever. The doc could not figure out; baby had seizures due to hypocalcemia; dehydration ( no feeding) ; baby was in ICU; transferred to Wadia and diagnosed with klebsiella and mild GERD; admitted for almost 15 days and discharged with instructions to elevate head; thick formula and anacids; however, the cough; intermittent cough and fever is not resolved yet; he is on steroid inhaler; currently has cold, cough and wheezing.
My question: why he has persistently intermittent fever; almost 102F?
Why he still has cough?
Will steroids affect his height?
Is th is related to GERD or ashtma as an atypical presentation of GERD? or something else is going on with underlying inflamatory condition?

The baby is active and cognitively well fucntioning.
I read that you are also specialized in respiratory medicine. I am eager to receive feedback and insights from you.
Thanks and have a great day.
Best Regards,
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answer:My question:
why he has persistently intermittent fever; almost 102F?
====== i clearly could not get from your info that how often how many days.. the efver used to come. i would say, intermittent cant be continuous. we call fever more than 15 days at a stretch as persistant, and fever coming not more than one or 2 times a day as continuous. please provide details with dates,duration,frequency and also the fever free intervals in a month

Why he still has cough?
=== considering he is 1 year age now (please provide exact age), and considering that cough is every day since a year (details not provided), she should have some weight loss if theer is any major problem. the reasosn for cough related to day, night, allergen feeds, diet, vomit , breathless etc have different reasons and therapy. please detail.
Will steroids affect his height?
=== not the inhalational ones.

Is this related to GERD or ashtma as an atypical presentation of GERD?
=== possible but the baby will ned a repeat GER test at this age.
or something else is going on with underlying inflamatory condition?
== please post me xray images(pics) that may help me assess if any underlying issue.
as you had not provided email address, the answer is posted at site.