Diagnostic Dilemma - Pediatric Oncall
Author: Pediatric Oncall
An 8 years old girl presented with recurrent fever for past 1 month. She had an exanthematous rash 2 months ago along with fever that subsided in 3 days. Now she has fever with chills and rigors for one week. There is no cough, vomiting, bladder or bowel complaints. On examination, she had soft hepatomegaly. Other systems were normal. Investigations showed:

• Hemoglobin = 11.4 gm, dl
• WBC count = 6,900, cumm
• Platelet count = 3,52,000, cumm
• ESR = 40 mm at end of 1 hour
• Urine routine and culture = Negative
• Liver function tests = Normal
• S. creatinine = 0.8 mg, dl
• Widal test = Negative
• Stool = Normal
• USG Abdomen = Bilateral pleural effusion with ascitis and gall bladder wall thickening.
• Dengue IgM = 1.55 AI { More than 1.1 = Positive}, Dengue IgG = Negative
• OptiMAL for malaria = Negative

She was treated with ceftriaxone and Amikacin for 7 days to which fever responded.
Answers of this discussion
Author :- avinash pudrod on 28 June 2014.
Answer :- No she doesn`t has any thing that fits into criteria of dhf

Author :- lijy on 30 June 2014.
Answer :- dengue hemorrhagic fever

Author :- farzandali siddiqui on 01 July 2014.
Answer :- no dhf

Author :- milind sadavarte on 02 July 2014.
Answer :- no there is no thrombocytopenia and also no fall in pcv

Author :- Emily Clark on 03 July 2014.
Answer :- yes she is

Author :- majeed sattouf on 04 July 2014.
Answer :- not dengue

Author :- Rimal Bramania on 05 July 2014.
Answer :- no she is not

Author :- ARUN CHATTERJEE on 07 July 2014.
Answer :- no, it doesn,t appear to be dhf because of absence of hmg, rash, features of shock, normal platelet. rather it appears enteric fever.

Author :- sid mal on 07 July 2014.
Answer :- nou possible.

Author :- arvind maloth on 08 July 2014.
Answer :- Nope

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