Presentation on theme: "INFANT WITH ACUTE LIVER FAILURE. 1.5 months, male, born of non consanguineous marriage, 1 st by birth order, birth weight 2.9kg, with h/o: Yellowish discoloration."— Presentation transcript:
1.5 months, male, born of non consanguineous marriage, 1 st by birth order, birth weight 2.9kg, with h/o: Yellowish discoloration of eyes and skin since 3days Abdominal distension with increased frequency of stools since 2days Fever since 1day
ON ENQUIRY: Child apparently alright 3 days back when he developed; Yellowish discoloration of skin and eyes with high colored urine No clay colored stools. Abdominal distension progressively increasing leading to respiratory distress. Stool frequency 9-12 episodes of green stools/day
One episode of malena. H/o fever, low to moderate grade for one day No h/o prolonged neonatal jaundice, No h/o seizures, No h/o refusal to feed or decreased urinary output. Birth h/o : Uneventful Development h/o : Normal Family & Past history : Not significant
GENERAL EXAMINATION Drowsy, afebrile; HR=124/min, pulses well felt; RR=58/min, subcostal retractions+; SPO2=98 on room air BP= 74/46 mmHg, HGT -30 mg/dl Anthropometry: Weight -4.2 kg,10 th centile, Length -52cms, 5 th centile. Icterus+++,Pallor+, No dysmorphic features. No cataracts. No skin changes.
IMPRESSION Hyperacute liver failure unlikely due to infection alone; D/D: In born error of metabolism precipitated by an infection. TORCH Infection – but no h/o antenatal illness or prematurity or IUGR, Normal at birth, until 3 days before admission
INITIAL MANAGEMENT O2 by hood I.V Fluids to maintain Euglycemia Blood Cultures collected 1 st dose antibiotics given Inj Vit K i.v