ISSN: 2642-6250
Authors: Suresh K*
A febrile seizure is a convulsion in a toddler or a child that's caused by a fever, from an explicit or implicit infection. Febrile seizures occur in young, healthy children who have normal development and haven't had any neurological symptoms before. Febrile seizures are common, occurring in up to 5% of children in the United States and up to 10% in India. Frequently perceived by caregivers as a life-threatening event, results in panic even among young, educated parents and accounts for emergency department visits and hospital admissions. It is not clear why some children have a febrile seizure following fever due to viral or bacterial infections, but they do occur due to abnormal increased electrical activity in the brain. Fortunately, febrile seizures are usually harmless, lasting for a few minutes, and don’t signify any serious health problem. The Primary Care Physician/ Provider (PCP) must be able to address young parents’ concerns as the first Pyrexial Seizure of a young infant or even a toddler, as they become panicky and calming them down is equally important as much as the treatment of the child. Most common precipitating cause for fever in febrile seizures are Upper respiratory infection (URI), Acute gastroenteritis (AGE), and Urinary tract infections (UTI). The causative organisms are usually viruses (RSV, Influenza, SARC-V 2, Roseola Virus) and Bacteria. However, the development of childhood vaccines over the past several decades has led to a significant reduction in childhood bacterial meningitis, whooping cough, Diphtheria etc. but streptococcus pneumonia and staphylococcus aureus bacteria with no vaccines are the common causes for hyperpyrexia. Most hospital studies indicate that about 15% cases prove positive for blood culture and another 7% are positive for urine culture. Management of Pyrexial seizure involves using Paracetamol and or Ibuprofen syrup or tablets every 3-4 hours and Diazepam if the seizures or long lasting or repeated. Bactrim (Sulfamethoxazole 40mg/Kg body weight and Trimethoprim 8mg/Kg body weight) suspension divided in 2 doses is given each day for 5 days for urinary infections. Material and Methods: This article is based on distant counselling the parents and managing two Fever Seizure cases one a girl of 6 years in Belgaum, Karnataka India and another a toddler of 17 months in San Jose, SFO, USA both my grandchildren in October 2023. The girl case was poorly investigated, and unnecessary broad-spectrum antibiotics given initially and, in the repeat attack, were administered standard Bactrim antibiotic. The boy in San Jose was investigated with 20 panels of pathogens in the first 4hours of emergency consultation and managed with only Paracetamol and Ibuprofen, no antibiotic.
Keywords: Fever; Respiratory Viruses; SARS-Cov-2 virus; Influenza Virus; Roseola Virus; Respiratory Pathogen Panel Test; WIDAL Test; Paracetamol/Tylenol; Ibuprofen; Bactrim
