|
|
|
| SPECIALIST ANSWERS
|
Question |
|
What D.D. do you suggest for a child of 4 months with R.D,fever,cough,lymphocytosis 90% ,neutrophil 6%,total count 16,000 ,esr 90mm ,CXR,bilateral mottled shadow ,PPD -ve ,PBF no abnormal cells ,bonemarrow no abnormal cells ,clinically few notes and hepatospleenomegally. Poor response to AT therapy ,although use of addtional steroid ,reduced ESR to 30.
|
|
Answer |
|
Rule out congenital infections in this child as
the child is 4 months old with mottled shadows on Xray chest and
hepatospleenomegaly. Look for other signs such as cataract, heart
disease and CNS manifestations. Since the child seems to have predominantly
lymphocytosis, chylamydia pneumonia should also be kept in mind.
TORCH titres will be useful. Also, it would be worthwile to rule
out HIV infection.
|
|
|
|
|
|
|
