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Question Category:Diagnostic dilemma |
a newborn, termbaby,3kg, mother having no positive history,brought in half hour of delivery with grunting and severe respi distress.cried imm after birth acco to obstetrician. as baby was in intermittent apnea,and sao2-50%. baby was intubated and blood was coming out of endotracheal tube(nontraumatic intubation). baby was put on ventilator but baby sao2 was 60-70% on fio2-1 and pip-25. rates-30. xraychest was done in 3 hrs of birth which showed total whiteout in both lung fields.the sao2 never improved. usg chest ruled out possibility of cong diaphragmatic hernia. finally baby succumed to death in 20 hours as the sao2 did not improve and gradually fall down. endotracheal suction revealed bleeeding intermittently. baby conscious and passed urine 4 times and stools once. what could be the diagnosis
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Question Category:Diagnostic dilemma |
please suggest some condition where patient not able to walk in straight line ,high step gait,search for support while walking ,Walk looking straight without looking down on floor,not able to recogonise some relatives MRI NAD no h/o fever,headach,vomitting,Age 7 years asymptomatic 15 days back thease symptom develop after 7 days loose stool.Other systems NAD,CNS concious eat normallywalk with support
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Question Category:Diagnostic dilemma |
I would like to have most probable diagnosis of an infant (3mnths) with persistent anemia(requiring regular transfusions since birth) failure to thrive, delayed development, only hepatomegaly on examination, candidiasis, with history of 3 sibling deaths at 3-6 months of life, consanguinous marriage of parents.. following investigations were normal- TORCH, HIV, BONE MARROW ASPIRATION, THALASSEMIA PROFILE (except low serum iron), SKELETAL SURVEY, ONLY LFT's WERE DERANGED with hypoalbuminemia, raised SGPT.
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Question Category:Diagnostic dilemma |
I would like to have most probable diagnosis of an infant (3mnths) with persistent anemia(requiring regular transfusions since birth) failure to thrive, delayed development, only hepatomegaly on examination, candidiasis, with history of sibling deaths at 3-6 months of life, consanguineous marriage of parents.. following investigations were normal- TORCH, HIV, BONE MARROW ASPIRATION, THALASSEMIA PROFILE (except low serum iron), SKELETAL SURVEY, ONLY LFT's WERE DERANGED.Could it be a storage disorder? He has a history of septicemia with hyperbilirubinemia requiring phototherapy and then herpes hepatitis in neonatal period but repeat herpes titres at 2 months of age were normal. Although thyroid function tests were never performed so could it be due to hypothyroidism too??
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Question Category:Diagnostic dilemma |
9month male complaining of generalized tonic clonic convulsion without fever since 1month his antinatal,natal&POSTNATAL HISTORY WAS NORMAL,FAMILY HISTORY +VE FOR MIGRANE NO HISTORY OF EPILIPSY.HIS INVESTIGATIONS: CBC.URA.ELECTROLYTES.BL SUGARE WERE NORMAL .EEG&CT SCANE ARE NORMAL
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Question Category:Diagnostic dilemma |
what are the management options for the subdural hygroma presenting with the seizures, no signs of raised ict or the mass effect, or focal deficit
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Question Category:Diagnostic dilemma |
4 months old male child came with fever, irritability since 2 days. Infant was feeding well till then. There was h/o third dose of DPT/Polio given 2 days back. Was given Paracitamol. Next day fever & irritability continued coupled with refusal to feed. On examination : Temp. 99degF, Heart rate 110 per min. , RR 40, AF being narrow could not be well appreciated. ENT – Normal, Per abdomen – Soft, Liver 1cm palpable – firm, Spleen not palpable, Baby was then admitted & put on maintenance I.V. fluids. CBC showed : Hb 11.3, WBC 10100, N49, E2, L49, Low Platelets of 63000.Smear for Malaria parasite negative. Fever subsided but irritability & refusal to feed continued for next day. Repeat CBC on second day of admission showed Hb 11.1, WBC 8300, N36, E5, L56, M3, Platelets dropping further to 55000, Serum Proteins 7.9 with albumin 3.6 , SGPT 385, PT 14 with control 14, PTT 39 with control 29, Serum Electrolytes : Na 145, K 5.2, Cl 109. Child is haemodynamically stable with good urine output. What is the probable diagnosis and further line of treatment?
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Question Category:Diagnostic dilemma |
Ivona, 19 months old baby girl was born with 6 toes, and diagnosed with increased kidneys (they were not fully developed) and hypocalcaemia; she was treated at the University Child Hospital in Belgrade, Serbia. She was released from the hospital after 7 days, without any particular diagnosis, and parents were advised to continue to bring her for regular check-ups. Regular pediatric check-ups did not find anything irregular. Over time, her kidneys have developed to the right size, and her level of calcium was normalized. Within the first two months, only breast fed, she weighted 7.2Kg (3.5 kg at birth), and even today, she continues to have a high appetite for her age. Compared to other kids of her age, she sleeps less, cries a lot, and hasn’t lost any weight, after being put on reduced calories diet. She started walking when she was 16 months old, and isn’t as stable as should be, she is also unable to get from a sitting to a standing position. Until now, she hasn’t spoken a single words, the only sound she makes is when she cries. She doesn’t react to calls (and her hearing is fine, as confirmed by ear specialists). When Ivona was 18 months old, child psychologist confirmed that Ivona is falling behind in her development, and that she is at the level of 11 months old baby. She is also diagnosed with strabismus, astigmatism, and shortsighted on one eye. Neurologist suggested that she may have metabolic abnormalities related to amino acids and the blood analyses. In the meantime, as we are still waiting for the blood results and final diagnosis, dialectologist-physical therapist are working with her every other day, 45 minutes and she attends toddler school for an hour per day, but only cries and shows no interest in the other kids. She is drinking plenty amounts of liquids, mostly water. I believe her baby bottle has more of a calming effect, than she is thirsty. She is almost constantly crying, very sadly, like she is asking for help, but we are unable to do so. She loves to be comforted, reaches to everyone, no matter if it a stranger or close relative. When her parents are back from work, she doesn’t react, interact with them, or doesn’t show any signs of happiness, as she doesn’t recognize them as her parents. On the other hand, she looks for her water bottle, and cries when she doesn’t find it.
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Question Category:Diagnostic dilemma |
An appearantly normal 3.5 years old girl child is passing stool which contains blackish fly like insects which really fly on coming out from body.What is the diagnosis and treatment?
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Question Category:Diagnostic dilemma |
children in the age group of 5-15yrs presenting with fever 7 days, asicitis, bilateral pleural effusion, some with seizures, delirium,no icterus or pallor,hepatosplenomegaly in some, dengue and malarial test negative.mild liver enzymes elevation in 100s,with prerenal failure..., lepto igM positive, but mat for lepto normal panbio <3 units..... currntly treated as gram neg sepsis. what else could it be?
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Question Category:Diagnostic dilemma |
13 yrs old male child presnted with a h/o fever since 2 weeks, developeda maculo papular erythematous rash all over the body on 3 day of fever.on 8 th day rash faded but fever persisted. there was sever cheilitis with lip cracking on fifth day of fever.fever subsided on 10 th day but again started on 13 th day. there was a h/o increased bowel movements during the episode.h/o cough +.h/o throat pain+.h/o desquamation from ther finger tips from the 10 th day on wards including feet. on examination child was sick looking malnourished pallor+ cyanosis-jaundice- jugulo diagastric lymphadenopathy+ posterior cervical nodes both sides palpable no pedal edema vitals stable systemic examinations normal on investigations Hb is 11 gm% platelet 5.48 lacks ESR is 70 1sthr, 140 2nd hrs all oter investigations normal including CBP<CUE< montoux was negative
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Question Category:Diagnostic dilemma |
dear sir, a one year old child presented with obesity (17kg, mentally normal,milestone normal ),sever metabolic acidosis,shock and convulsion.child died within a day.what could be the possible diagnosis?
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