Urosepsis With Multi Organ Dysfunction In A Teenage Girl

 Dr. Anirban Basu (Consultant Paediatric & Neonatology - Ruby General Hospital)



 



A 13-year-old female girl had been admitted under the care of Dr. Anirban Basu (Consultant Paediatric) with complaints of abdominal pain, fever and vomiting for the last seven days, along with decreased urine output for three days prior to admission. On admission the child was toxic, had multiple episodes of vomiting, decreased urine output, but was not in shock. She was evaluated and relevant blood and urine investigations were done. The Liver Function Test (LFT) and Renal Function Test (RFT) results were deranged. The creatinine level was high and CRP level was 372.4, while, there was presence of pus cells and RBC in the urine. The blood pressure was within normal range throughout, eventually, she was started on antibiotics which were adjusted as per renal dose as the creatinine level was high along with IV fluids bolus followed by maintenance of fluid, post which, the urine output increased. Simultaneously, conservative treatment had been given along with the above treatment. The CRP level decreased to 142.1 by the fourth day of antibiotic infusion and the child was gradually improving clinically with increased urine output. The opinion of a nephrologist had been taken and his advice was duly followed. Few investigations had been advised like Complement C3, Peripheral Blood Smear (PBS) for Schistocytes (Fragmented red blood cells suggesting red blood cell injury from damaged endothelium and is a characteristic feature of microangiopathic hemolytic anaemia), Lactate Dehydrogenase (LDH), Vitamin D, and Parathyroid Hormone (PTH). Urine for fungal hyphae had been advised in view of diagnosing if any pathology lay in the kidney such as Glomerulonephritis (Inflammation of the tiny filters in the kidneys known as glomeruli) as there was presence of RBC in the urine. The child gradually improved clinically and in four days time the urine output increased considerably, the CRP level was powered down, creatinine decreased from 3.3 to 2.5 and then to 1.3. It was finally diagnosed as a case of urosepsis (Type of sepsis caused by an infection in the urinary tract) with multi organ dysfunction. The parents of the child were very happy and thanked Ruby Hospital as they believed that it was for RubyHospital that they could take their only child back home safely.

Location: Kolkata, West Bengal, India

Comments

Post a Comment

Popular posts from this blog

Dengue Adds To The Woes Of COVID Pandemic | Ruby General Hospital, Kolkata

Image
Dr. Raktim Guha (Consultant  Critical Care  -  Ruby General Hospital ) A gentleman of over 50 years had been presented in the Emergency Department of Ruby General Hospital with complaints of severe weakness for the last seven days along with fever and was admitted under the expert care of Dr. Raktim Guha (Consultant Critical Care ) . The gentleman was febrile initially and had dengue fever with uncomplicated course previously. On presentation he had severe body ache and rashes over the anterior part of the body and both upper limbs. Considering the pandemic scenario keeping in mind all the probabilities, a thorough evaluation had been done which revealed dengue fever and SARS-CoV-2 infection. The platelet count had been very low (22,000) with increased haemoglobin and P.C.V., so a close watch was kept on two parameters, hydration which was maintained properly with IV fluids, and coagulation profile as the liver function was deranged, which is very common in repeat deng...
Read more

Professional Singer Begins Singing Anew

Image
U/Dr Prasanna AV ( Consultant Neurosurgeon - Ruby General Hospital ) We always consider home as the safest haven but, sometimes emergencies take place in the safest of places. Brain hemorrhage is a catastrophic event in any one’s life and it causes a lot of neurologic disabilities like disability and is a leading cause of death today. A 68-year-old professional singer had been presented with a history of fall at home resulting in total paralysis of right sided limbs (Hemiparesis) and was unable to speak. He was deteriorating rapidly and was admitted under the expert care of Dr. Prasanna AV (Senior Consultant Neuro Surgeon ) who thoroughly evaluated him and relevant investigations were sent for. The MRI revealed left sided subdural haematoma (A pool of blood between the brain and its outermost covering). The gentleman was a known case of Hypertension and Type II Diabetes Mellitus. After discussion with the family members and with informed written consent the gentleman was posted fo...
Read more

Mother back to her newborn after battling covid, jaundice and pancreatitis

Image
Dr. Prerna Pallavi ( Consultant Gastroenterologist  -  Ruby General Hospital ) 33 years old lady, presented to her treating specialist after she suddenly developed  pain abdomen and jaundice  in last trimester of pregnancy. After initial evaluation she was diagnosed to have jaundice with gall stone disease and hence was taken up emergency caesarean section (outside). However post-surgery she continued to have jaundice with worsening pain abdomen and hence presented to us for further management.  At presentation she was conscious oriented, had  SIRS , mild respiratory distress and abdominal distention. Her covid status was positive with mild disease on HRCT, mixed pattern of jaundice, leukocytosis, b/l pleural effusion with necrotizing pancreatitis and evidence of gall stone disease with no biliary obstruction.   She was started on standard management protocol for covid and  pancreatitis  along with other supportive treatment. With a good nurs...
Read more