Page 152 - ITPS-7-2

INNOSC Theranostics and
Pharmacological Sciences From fever to seizure: A pediatric case study

Table 1. Biochemistry test patients prone to seizures or neurological disturbances.
Patient counseling focused on understanding febrile
Biochemistry Day 2 Normal values seizures, recognizing signs, adopting preventive measures,
Serum Ca +2 9.9 3.8 – 10.6 and knowing when to seek medical attention.
Serum Mg +2 2.5 1.6 – 2.6
3. Discussion

Table 2. Complete blood picture FSE represents a critical end of the spectrum in
febrile seizures, characterized by seizures lasting over
Hematology Day 1 Day 3 Day 5 Normal values 30 min. It poses significant challenges, especially in
Hemoglobin 12 12 11.8 11 – 15.5 g/dL pediatric patients, necessitating immediate and tailored
1-3
Red blood cells 4.7 4.8 4.7 4 – 5.2 million/cumm interventions. A 1-year-old baby boy was admitted
White blood cells 40.9 18.5 9.6 5 – 13 thousand cells/cumm with a 5-day history of high-grade fever, vomiting, cough,
Platelets 3.24 2.19 2.35 1.8 – 4.5 hundred thousand and a seizure lasting 20 – 25 min, displaying ocular
cells/cumm deviation and generalized tonic–clonic features. Upon
examination, he presented with a temperature of 102°F,
an elevated heart rate of 162 bpm, and a respiratory rate
Table 3. Electrolytes test
of 24/min. Hematological and biochemical investigations
Electrolytes Day 1 Day 3 Normal values revealed fluctuating parameters, including variations in
Na + 137 141 136 – 145 mmol/L hemoglobin, red blood cell, white blood cell, and platelet
K + 3.3 4.3 3.5 – 5 mmol/L counts. In addition, electrolyte imbalances were observed.
Cl - 99 105 95 – 105 mmol/L Imaging through MRI revealed normal myelination.
Treatment encompassed a combination of antibiotics,
anticonvulsants, and supportive care, leading to a gradual
Table 4. Renal function test (RFT) resolution of symptoms. The patient achieved a 48-h
afebrile state and was discharged with modified medication.
RFT Day 3 Normal values The case highlights the complexity of managing FSE in
BUN 14 10.8 – 38.4 pediatric patients. The prolonged seizure episode, along
Sr.Cr 0.3 0.2 – 0.4 with the constellation of symptoms, posed diagnostic
Uric acid 1.1 3.5 – 7.2 and therapeutic challenges. Laboratory findings indicated
Abbreviations: BUN: Blood urea nitrogen; Sr.Cr: Serum creatinine. fluctuations in hematological parameters and electrolyte
Table 5. Treatment chart

Drug given Dose Roa Frequency Pediatric dosing
Injection ceftriaxone 500 mg Intravenous Bd 50 mg/kg/day
Injection pantoprazole 10 mg Intravenous Od 10 – 20 mg/day
Injection ondansetron 1 cc Intravenous Bd 0.1 mg/kg
Injection levetiracetam 200 mg (S)/50 mg Intravenous Bd 10 mg/kg/day
Tablet clobazam 5 mg Oral Bd 10 mg/kg/day
Syrup Paracetamol 3 ml Oral Qid 10 – 15 mg/kg
Syrup Cetirizine+Ambroxol 3 ml Oral Bd -
Paracetamol suppository 170 mg Rectal Sos -
Iv infusion of ½ dextrose normal saline 40 mL/h Intravenous -
3% Normal saline nebulization 2 drops E/S Nasal Tid -
3 cc
Injection meropenem 200 mg Intravenous Tid 20 mg/kg
Injection linezolid 100 mg Intravenous Bd 10 mg/kg
Bacillus clausii capsule 1 capsule Oral Bd -
Syrup levetiracetam 0.5 ml Oral Bd 10 mg/kg/day
Abbreviations: Bd: Twice daily; E/S: Each side; Iv: Intravenous; ns: Normal saline; Od: Once daily; Roa: Route of administration; Sos: Whenever
required; Syp: Syrup; Tid: Thirce daily.

Volume 7 Issue 2 (2024) 3 doi: 10.36922/itps.2735