Cert ID(SA) Paed Practice Questions - CMSA Sub-specialty Certificate In Infectious Diseases Cert ID(SA) Paed - South Africa Exam

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A 2-year-old child presents with a 2-week history of lethargy, low-grade fever, vomiting, and cranial nerve VI palsy. Lumbar puncture demonstrates xanthochromic CSF with elevated opening pressure, clear fluid, WBC count 280/mm³ (85% lymphocytes), protein 2.4 g/L, and CSF glucose 1.1 mmol/L (simultaneous blood glucose 5.5 mmol/L). GeneXpert Ultra on CSF detects M. tuberculosis (medium). What adjunctive therapy is critical to reduce mortality and neurological sequelae in this child?

High-dose Intravenous Immunoglobulin (IVIG) for 5 days Intraventricular Streptomycin instillations Interferon-gamma adjunctive therapy for 2 weeks Systemic Corticosteroids (Dexamethasone or Prednisolone) for 4–6 weeks

Correct Answer:

Systemic Corticosteroids (Dexamethasone or Prednisolone) for 4–6 weeks

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