What Specialist should I consult?
Born: 16 August 2000
History: Born at term, in eutocia after a normal gestation.
Reason for hospitalization: In May, he was affected by chickenpox. About one month later he had fever and a convulsive attack, and entered the Intensive Care Department of our hospital, where an ECG showed a AVB; a temporary pacemaker was applied (Cardiology Division, Monaldi Hospital) and complete amaurosis.
Neurological exam: The patient was awake, with fixed mydriasis; ocular fundus optic disk palness in both eyes.
Main examinations: Heart examination and ECG. Pacemaker rhythm 100 bpm; atrial rhythm dissociated at a 88 bpm. Echocardiogram. Normal global contractility. Pacemaker in position. Slight tricuspidal
insufficiency and slightly mitralic. Limited dyskinesias of the apical segment of the right lateral-posteral wall. Control after a month. Ophthalmological exam. In both eyes, healthy annexes, fixed mydriasi of the eye and the eye not reactive to light, transparent dioptric structures, at the ret
No I am not a doctod, just desperate to help a child.
retinal posterior pole, the optic disc appeared with clear margins and of a very pale colour particularly in the left eye, the retinal veins were normal as regards emergence, course and size.
Evoked visual potentials. Trace morphologically irregular upon stimulation in both eyes, not repeatable and with some difficult-to-identify components.
EEG: Cerebral activity awake and during sleep was slowed, and not well modulated.
Cranial CT. No pathological signs.
T.O.R.C.H. IgM not present. Cytomegalovirus 2100 IgG, Herpes simplex 5900 IgG.
Encephalic NMR. Not performed because of the pacemaker.
Clinical course. Stationary because of amaurosis. At present there is good hemodynamic compensation.
Diagnostic hypothesis. Post-infection syndrome.
Programme:
Repeat evoked visual potentials exam after three months. Cardiological control after a month. Neurololgical control after 30 days.
Treatment: MEDROL CP 4 mg: 1 CP in the morning for three days, then suspend. ZOVIRAX SYRUP: 200 mg twice
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Where have you gone so far? Its sounds like you've covered some specific Cardiac and Occular places. Have you checked wih Peds specific specialties?
What's the CC right now? If the problem is still cardiac, have you seen a Pediatric Cardiologist? Has the Fever been knocked out? If the issue is still occullar AND you feel the medical staff don't have your child's best interest, get a second opinion from another Opthalmologist from a different location.
I will admit, vision is not my best area.
G-Dspeed in your child's recovery. (
+ info)
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