A. Iliescu *, B. Oprița **, C. Pandrea **, Rodica Ciolacu **, Daniela Motocu ***
* Dr. lliescu A. – medic rezident MU
** Dr. Oprița B., Dr. Pandrea C., Dr. Rodica Ciolacu – medici specialisti MU
*** Dr. Daniela Motocu – Medic rezident MU; Asistent de cercetare
Abstract
The etiological indeterminate comas at children always represented a real challenge for the E.R. doctors. The specific pathology of children entails quite often difficult problems concerning differential diagnosis. Such situations require profound knowledge of the physiopathological mechanisms that trigger comas, complemented by a strict therapeutical approach and an efficient management of the case. The lacking medical education of the parents, inadequate babysitting, precarious hygiene, easy access to various toxic substances such as drugs and poisonous chemicals, as well as a superficial anamnesis of the physician and an incorect evaluation of the case could lead to dramatic situations, and eventually to the death of the child. This article presents the concrete case study of a 2 years old child diagnosed with ,,etiological indeterminate coma”. The particular aspects concerning this case are the lack of anamnestic data, the inadequate therapeutical approach, the final diagnose, and most importantly the triggerring factor, the administration of NeGram (nalidixic acid). It must be pointed out that although the administrated dose was 2 times smaller than the recommended dose for his/her age, the child presented convultions (an adverse reaction listed in the drug’s presentation document as a rare occurance for the optimal weight/age dosage) followed by the loss of consciousness.