8yrs old male boy admitted on 3/9/18 with complaints of Fever,Headache and vomitting for one days,there is a Hx of hydrocephalus when he was 8mnth old,For which Ventriculo peritoneal shunt was done at the age of 8mnth.No neurological deficits present. O/e Conscious,Awake and oriented,Febrile 38.7°c.GCS - 15/15,Moving all four extremities,Pupils bilaterally 4mm RTL.vitally stable.Patient improving symptomatically. What could be the possible reason behind this headache and fever and what should be done??

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One day history of fever , head ache & vomiting .Active child no focal deficits. Symptomatically better.CT mild hydrocephalus , shunt tube in situ. Shunt infection usually severe. Probable simple viral fever.

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Check for shunt chamber compression and refill. Send a CSF from lumbar puncture for routine and c/s. Start with iv antibiotics. Get a repeat CT done after 48 hrs to look for any ventriculomegaly. If CSF comes out to be infective , the shunt had to be removed.

Very less likely to be an infected/blocked shunt. Could be a viral fever Treat symptomatically

Hydrocephalus is there ,but if fundus is normal and history of one day and no clinical deterioration , manage symptomatically

No fever,Headache now Tomorrow will discharge

Shunt block,shunt meningitis

Yes don't relate this with shunt evetytime or could be just viral infection

Early signs on ct of impending shunt block Shunt has worked for 8 years Now is time to replace it.

Hydrocephalus with VP shunt could be shunt infection Shunt block

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