Baby of Sujitha

Age: 10 Days/ Male

Funded by HAC: 75,000/-

Clinical History:

Baby of Sujitha was brought to NICE hospital at 66 hours of life. Baby presented with shock, respiratory distress and neonatal seizures. Initially downes score was 7. The child was ventilated immediately. IV antibiotics was started in v/o sepsis ( Meropenem and Vancomycin).  Antiepileptic was started (Phenobarbitone). Dyselectrolytemia was present Potassium was high, calcium gluconate given. Later insulin infusion was started in v/o hyperglycemia. Shock was managed adequately inotropes (dopamine, dobutamine, adrenaline and noradrenaline) were given. In view of candida sepsis fluconazole was started later changed to amphotericin B according to sensitivity of fungal culture. Later phenytoin and levetiracetam were added to control seizures. Baby had seizures on 3 antiepileptics, so midazolam infusion was started and tapered after 2 days. Then baby had hypoglycemia and after initial management he was given hydrocortisone infusion. EEG showed generalized epileptogenic focus. NSG done on DOL- 6 was normal. 2 D echo was normal. As CAH was suspected for dyselectrolytemia and fluctuating glucose levels CAH Panel was sent. USG showed mild hepatomegaly. Eye examination for any evidence of TORCH infection was done which was normal. Baby was shifted from mechanical ventilation to high flow and minimal feeds started.

Baby of Sujitha is saved at a cost of 75,000/-.