Question
Case Report: - A 7 year old girl born of non consanguineous marriage presented with fever for 1 week and anorexia and weight loss for 3 months. She was on Antituberculous Therapy {ATT} since 3 months in view of Chest X-Ray suggestive of Miliary TB with positive Mantoux test. However drugs had been stopped for past 10 days due to epigastric pain and tingling numbness. There is no contact with Tuberculosis. On examination, she was malnourished {weight = 12 kg., height = 108 cm}, had hepatomegaly with bilateral crepitations. Other systems were normal. Investigations showed:

• Chest X-Ray = Right lower zone pneumonia and small pneumothorax
• Liver enzymes = Twice elevation
• CT Chest – Multiple cystic lesions ranging from 5 mm to 10 mm noted in bilateral lung fields with pneumonia on right side and multiple small abscesses seen in both lobes of liver
• Hemoglobin = 11.5 gm, dl, WBC count = 18,700, cumm {polymorphs = 84 percent, lymphocytes = 15 percent}
• ESR = 108 mm at end of 1 hour
• HIV ELISA = Negative
• GL for AFB = Negative

Child was shifted to 2 drugs ATT.