Hello doctor, My 9-month baby girl has nine days of fever (every 6-8 hours). First four days antipyretic was given. From fifth to the eighth day, Cefixime oral was given. Ceftriaxone injection till now and the fever is not fading away. Test like CBC, CRP, Epstein Barr agar, blood culture, urine culture is done. Please help.
Hello. The clinical features and reports you have shown are indicative of the infection. But and the infection looks like a bacterial origin because of predominantly elevated neutrophils and CRP. The common infection in this age group are urinary tract and respiratory tract, but other sites may get infected e,g. Abdomen. We do tests sequentially. I want to do urine examination for routine and culture, and blood culture should be repeated with an adequate amount of blood, ultrasound abdomen to look for any evidence of infection e,g, abscess, pyelonephritis. Another thing is we should so repeat CBC and CRP to look for improvement. And if your child is irritable with poor feeding, then my dear we should also thought of meningitis that is infection of brain. For this get done a CECT head and lumbar puncture and examination of the CSF. Therapeutic intervention in your case, although Ceftriaxone is a good drug but in such young child and we should give two antibiotic combination e,g, Ceftriaxone and Amikacin. Because of the better cover of the causative organism.If she has respiratory symptoms, then a chest x-ray is indicated, and after that, we can add other drugs also depend on the finding of the x-ray. So, ask your doctor to do all these intervention and monitoring of the inflammatory parameters. And review back with detail reports or before that if you need more discussion.