What could cause high fever, convulsions, and general malaise in a 4-year-old?

Question

Hello doctor,

My 4-year-old child has been experiencing high-grade fever, vomiting, headache, diarrhea, and general malaise for the past two days. She has had several episodes of convulsions, passed deep-colored Coca-Cola urine, and appeared confused. On examination, her Glasgow coma scale is 12, random blood glucose is 1.5 mmol/L, and she is febrile at 40 degrees Celsius. Physical findings include hepatomegaly, negative Kernig and Brudzinski signs, and a positive modified Denver shunt test (MDRT). Her weight is 33.069 pounds. Could you please guide me in managing my child and discuss potential complications?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Based on the clinical presentation and MDRT (modified Denver shunt test), I suggest it is an infection, likely malaria (a disease caused by a mosquito bite). Therefore, initiating antimalarial treatment is highly advisable to prevent potential complications. Further complications may include conditions like jaundice (yellowing of skin and eyes due to excess bilirubin), renal failure (kidney failure), sepsis (body's extreme response to infection, causing organ dysfunction), and, in severe cases, even shock (inadequate blood flow to tissues, risking organ failure).

The choice of treatment depends on the type of malaria. For P.vivax (Plasmodium vivax), consider initiating Chloroquine and Primaquine therapy, and for P.falciparum (Plasmodium falciparum), initiate ACT (Artemisinin combined therapy). I suggest confirming the type of infection with the consulting doctor and then commencing the appropriate therapy.

I hope this helps.

Please revert in case of further queries.

Thank you.