Male1: If a child had a very high fever, was not focusing, the light bother his eyes and the pediatrician says that he is concerned about a serious infection, what is that all about?
Male2: Well, I think that the pediatrician might be concerned that that child has a high fever and is not acting normally, in other words, his brain function is not acting normally. Sometimes, that can be some children who get like that when they have a high fever, so the first step would be to decrease the fever and see what the child looks like.
If the child has a decrease in fever and is normal, then the pediatrician will be reassured, the parents will be reassured and everybody goes home. If however, the fever comes down and the patient is not acting normally with the fever now that it has come down, then the pediatrician would have to worry that there is a more serious infection in the nervous system such as a meningitis which can be sometimes bacteria or a virus that can affect the spine and the brain itself, which would mean that the patient would be transferred to the hospital and undergo imaging of the brain and looking at the spinal fluid to be certain that there is not an infection causing this change in the baby’s behavior.
Male1: So the most important thing is, assessment of the cause, bring the fever down to see if the kid still is not focusing or has some photophobia or the light bothers the kid’s eye and that could be a hallmark of something more serious and treatment must be given to the kid quickly.
Male2: That is correct. So if a patient with a fever down still looks different, not acting normally, one has to be certain that it is not a serious infection and it should be done on an urgent basis.
Male1: And like summer, a lot of kids end up in the emergency room and gets spinal taps for headaches. What is that all about?
Male2: Well, late summer is a common season when a certain virus comes out and it is usually an entero virus and the season usually lasts from July to September, sometimes early October. Every year is different and every year has its own patterns, but some years, it causes quite a lot in the way of viral meningitis. Sometimes, it will even produce seizures, and these patients will come in with a fever and a stiff neck, but look relatively good. And we will have a spinal tap done to make sure it is not a more serious kind of inflammation and once it looks viral, we can be reassured, and most of these children do in fact very well with no long term problems, but this is seasonal and it typically occurs in the late summer and most years, the children do very well with no long term problems.
Male1: Is there any particular group in pediatrics who are likely to have these problems than any other group?
Male2: I do not know the answer to that question. Anecdotally, I typically see it in children over age six so it is from six to adolescence, but I do not know if the data shows that.
Male1: So you are saying the bugs do not look at your age?
Male2: I think I see it more commonly than—it might be that it is noticed at that age, but I am not sure of the answer.
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