Case presentation of Febrile convulsions with Anaemia

1. A CASE PRESENTATION ON FEBRILE
CONVULSION WITH ANEMIA
Anvy thankachan
Pharmd 4 th year

2. • A 10 month old baby got admitted with a history of
febrile convulsion at home. She had a history of
fever for one day . On admission temp: 102 F

3. SUBJECTIVE
• Patient name : Mr. Y
• Ip No : H-1848
• Age : 1 yr
• Sex : Female
• Department : Pediatric.
• DOA :4 /12/2017
• DOD : 8/12/2017
• Weight :7kg

4. • History of Present illness :
Patient had a history of fever for one day.
She had a episode of febrile convulsion at
home
• Past medical history : Anemia

5. OBJECTIVE
5

6. Date 4/12/17 5/12/17 6/12/17 7/12/17 8/12/17
Temp 102 101.4 101.2 100.4 99.8
Vital signs
6

7. Parameters Normal value
Observed
value
4/12/17
Hb 13-15 gm 10 gm
TC 4000-11000 6500
Polymorph
cells
50-70 % 50%
Eosinophills 1-6 % 2%
Lymphocytes 20-40 % 41%
ESR 0- 20 mm/hr 14 mm/hr
Platelet count 1.5-4.0 L/mm3 2.6 lakhs
CRP 1-3 mg /dl 3.85 mg/dl
7
Laboratory Investigation

8. URINE ANALYSIS
Albumin Trace
Micro pus cells 2-4 pus cells
sug nil
5/12/17

9. Other Investigation
Peripheral smear: (4/12/17)
Hypochromic Microcytic RBC

10. ASSESSMENT
FEBRILE CONVULSION WITH
ANEMIA

11. • Febrile seizures are seizures that occurs
between the age of 6 months to 5 years
with a temperature of 38 C (100.4 F)

12. Classifications
Febrile seizures are further divided into two
categories, simple or complex, based on clinical
features :
• 1. Simple febrile seizures: the most common type,
are characterized by seizures associated with fever
that are generalized, usually tonic-clonic, last less
than 15 minutes, and do not recur in a 24-hour
period.
• 2. Complex febrile seizures: seizures associated with
fever that are characterized by episodes that have a
focal onset (e.g. shaking limited to one limb or one
side of the body), last longer than 15 minutes, or
occur more than once in 24 hours.

13. Signs and symptoms of febrile convulsions
During a febrile convulsion:
your child will usually lose consciousness
their muscles may stiffen or jerk
your child may go red or blue in the face.
• The convulsion may last for several minutes.
• When the movements stop, child will regain
consciousness, but they will probably remain
sleepy or irritated afterwards.

14. • Anemia occurs when you have a decreased
level of hemoglobin in your red blood cells
(RBCs) .
• Iron deficiency anemia is the most common
type of anemia, and it occurs when our body
doesn’t have enough of the mineral iron.

15. Iron deficiency anemia signs and symptoms may
include:
• Extreme fatigue
• Weakness
• Pale
• Cold hands and feet
• Brittle nails
• Unusual cravings for non-nutritive substances,
such as ice, dirt or starch (pica)
• Poor appetite, especially in infants and children
with iron deficiency anemia

16. IRON DEFICENCY – STAGES
• ♦ Prelatent – reduction in iron stores without
reduced serum iron levels • Hb (N), MCV (N), iron
absorption (↑), transferin saturation (N), serum
ferritin (↓), marrow iron (↓)
• ♦ Latent – iron stores are exhausted, but the
blood hemoglobin level remains normal • Hb (N),
MCV (N), TIBC (↑), serum ferritin (↓), transferrin
saturation (↓), marrow iron (absent)
• ♦ Iron deficiency anemia – blood hemoglobin
concentration falls below the lower limit of
normal • Hb (↓), MCV (↓), TIBC (↑), serum
ferritin (↓), transferrin saturation (↓), marrow
iron (absent)

17. Causes of iron deficiency anemia
• Iron deficiency anemia develops when bodystores of
iron drop too low to support normal red blood cell
(RBC) production.
Inadequate dietary iron
Impaired iron absorption
 Bleeding

18. DIAGNOSIS

19. Therapeutic Goal
• To reduce body temperature
• To correct Hb level

20. TREATMENT PLAN

21. 21
N
O
BRAND
NAME
GENERIC NAME DOSE&
ROUTE
4/12 5/12 6/12 7/12 8/12
1. P.Mol
suppository
Paracetamol Stat
80mg
+ + + + +
2. Midozolam Midazolam Nasal 4
puff
+
3. Medomol
drop
Paracetamol 1.5ml
Q6H
+ + + + +
4. T. FRISUM CLOBAZAM 5mg
1/2BD
+ + + + +
5. Inj. Taxim
250 mg
Cefotaxim Iv Q8H + + + + +
6 Syu.Ibugesic
plus
Ibuprofen+
paracetamol
2.5 BD
ml
+ + + + +
7. Inj. Amikacin Amikacin 65 mg iv
BD
+ + + +
8. Raricap drop Elemental iron 10 drop
BD
+ + +

22. 9 TUFF PRO Bacillus calusii stat + +
10 SYURUP ZENTEL Albendazole 5ml HS +

23. Discharge Medication
• Medamol drop 1.5ml sos
• Tab. Frisium 5mg ½ sos
• Syp.Zentel 5ml for 2 days
• Raricap 10 drop BD (1 bottle full)
• Syp. Cefolac 2.5ml BD for 5 days

24. Patient education
• Regarding Anemia:
• Giving the child a healthy diet that has iron-
rich foods such as green vegetables, egg
yolks, and fortified cereals and grains.
• Limiting the intake of cow’s milk in children - is
a poor source of iron and it actually interferes
with the body's absorption of iron.
• Add citrus fruits in the diet to increase the
iron absorption levels in the child.

25. • Regarding febrile seizures :
• Limiting exposure to viruses that cause upper
respiratory infections (e.g., by frequent hand
washing and avoiding contact with anyone
who is sick) may help reduce the risk for
illnesses that cause fever
• Use of fever-reducing medicines

26. • Regarding Drugs:
• Antibiotic given with out any sensitive pattern
• The dose of Paracetamol sholud be adjusted
since the given dose was above the safe range