Diagnostic Dilemma - Pediatric Oncall

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Gurmeet Singh, Reena Sood Department of Pediatrics and Department of Obstetrics and Gynaecology, Sh...

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Question Category : Diagnostic dilemma
A 9 yrs old boy brought in OPD with only presenting complaint of abdominal distention.No significant past history except some unexplained fever at the age of 4 yrs for 15 days treated successfully with antibiotics. Present abd. distention noticed by parents only 15 days ago.On examination he has prominent dilated veins over sternum distended upper abdomen with enlarged liver-2cms and grossly enlarged spleen almost up to the pelvis.His blood count shows anemia-Hb 9% and platelets 100,000 other parameters being WNL WHAT MAY BE PROV> DIAGNOSIS? WHAT INV. HE WILLNEED FURTHER? Check Out the Answer
Question Category : Diagnostic dilemma
a 14 yr old female child with h/o fever(recurrent episodes) for last 8 months and ?constitutional growth retardation,weighs only 25 kg with no sec sexual characters. has been investigated in cmc vellore,all reports including bone marrow and karyotyping are normal.only positive that urine c/s grew e.coli,sen to netro.presently on iv ab but main problem for last 20 days is persistent retching and vomiting not responding to any modality.ba studies,endoscopy,usg all are normal.has recvd rx for h.pylori also.any suggestions for future course/ Check Out the Answer
Question Category : Diagnostic dilemma
hi we have got a baby of annalaxmi in our nicu .the baby got transferred from pnc ward in view of jitteriness and excessive cry.reports suggested hypocalcemia ,was started on inj ca gluconate .rpt ca report showed normal values. till the first 3 days the baby was ok but on the third day c/t/a was depressed .rpt cbc and platelets showed drop in the platelet count,was stared on inj meropenem and inj ciplox i/v/o sepsis ,on the next day baby had slow irregular respiration rr:20-28 with episodes of apnoea in between,3 abgs consistently showed metabolic alkalosis like picture with normal o2 saturation and normal po2 pco2 levels.now the baby is off oxygen but is not fuuly active abd still showing metabolic alkalosis what should be done further,the serum electrolytes report was normal blood culture shows no growth done twice Check Out the Answer
Question Category : Diagnostic dilemma
There is 11yrs girl come with the complaint of pyraxia of unkown origin,fever of104c,pain in abdomen,vomiting,after some day treatment no progess in her condition and also all report are normal,now she is so week that she cant walk,did not go to toilet,further her doctor repeat her all investigation so in sonogaphy report there is mild asitis,query of kochs and aortic lymphadenopathy,spleenohapatomagali and her ane report is positive.so tell me what is diagnosis of her? Check Out the Answer
Question Category : Diagnostic dilemma
dear sir 9 yr. male with bilateral swollen knees with normal ESR &C REACTIVE PROTEIN. what are the d.dx? Check Out the Answer
Question Category : Diagnostic dilemma
5 year old boy had a fever for 4 days unresponding to antibiotics , he was given Augmentin 312 mg/5ml, in 3 divided doses , then the step came down , but he has bluish discolorations of upper and lower lips , and extreme fatigue!! , anyone has any idea what is the reason for this discoloration?? Check Out the Answer
Question Category : Diagnostic dilemma
5 years old male with one week history of fever 38-39 c* with generalized lymphoadenopathy high esr high crp high ldh 666 no blood growth no urine growth bruceela ag no malaria no normal rf ck high order cmv ebv no result yet ct scan brain normal lp not done so whats other differential diagnosis Check Out the Answer
Question Category : Diagnostic dilemma
I has a patient 2 months old. She has jaundice, failure thrive, persistent hypoglycemia, hyperamonemia, metabolic acid and non anion gap. Screening metabolic for galactosemia: negative, acylcarnitine profile: negative, aminoacid profile: negative. Can you help me? Check Out the Answer
Question Category : Diagnostic dilemma
a 7month old female child,fully vaccinated has presented with diarrhoea for few days followed by gross ascites, deranged liver function and proteinuria. urine reducing substance is positive though neonatal galactosemia screening was normal.ther is hypoproteinimia, urea, create normal with a high count-29,oootc. no icterus or anemia. the doppler of hepatic veins and ivc normal.what could be the possible diagnosis. Check Out the Answer
Question Category : Diagnostic dilemma
high fever,no focus, neutrophilia, not responded to augmentin, cefaxone,x raychest, usg,blood culture normal,repeat x ray on day 10 shows pleural thickening with minimum pleural effusion on lt side. guide about further management & antibiotic use. i hv started vancomycin & cefuroxime. Check Out the Answer
Question Category : Diagnostic dilemma
1 years old with multiple endocriny problem hypothyrodism IDDM skin rash and ecezma ?ipex association i want to know more about the case Check Out the Answer
Question Category : Diagnostic dilemma
12yr old boy with pallor, facial puffiness, pain abdomen for 1wk duration. O/e pallor, afebrile, no icterus, no sig. lymphadenopathy, facial puffiness , ent N , RS: mild distress, R crepts, air entry equal CVS: No tacycardia, no murmurs, pulse N PA : tender hepatomegaly , ascitis CNS : Normal vitals : BP 140/ 90 HR :100 RR: 34 crft/ pulse N labs: Hb: 7.2 urine : alb :4+, no rbc tc :7000 , n 67 l31 CXR : rll. Pneumonitis esr 25 & 30 smear : mild iron defi, USG :hepatomegaly,asicitis cholestrol : 102, B/L pleural effusion sgpt ; 12, ot ;14 protein ; 6.3, alb :3.3, ,renal funct ; Normal Check Out the Answer
Question Category : Diagnostic dilemma
a 6 years old male presented with fever followed by swelling of the face within 24 hours which was followed by necrotising lesion of the nasal cavity extending to the periorbital and ethmoid,maxillary and sphenoid sinus. there is no significant past history of repeated infections, chronic nasal discharge,or contact with T.B, No history S/O immunodeficiency or diabetes mellitus. There is history of 4 sibling sudden deaths in infancy, without any prior illness, cause not known. o/e THERE was crusted lesion with destruction of nasal septum with periorbital swelling. please suggest some differential diagnosis and the most likely diagnostic possibility. Check Out the Answer
Question Category : Diagnostic dilemma
a 2yr male child brought vit c/o polyurea(20 to 25 times/day)since 2 months.no h/o fever,o/e no failure to thrive,no oedema........child was stable. urine routine ,cbp normal.how 2 approach this case n what may be probable dx? Check Out the Answer
Question Category : Diagnostic dilemma
dear doctors, my doubt we have a hepatospleenomegaly(liver span-12 cms,spleen-5 cms) with no identifiable cause.all infective & metabolic investigations are negative.no h/o fever.as such the child had only come for parietal wall abscess and this was only incidental finding.child has b/l cervical lymphnodes.mild ascites.child is on antibiotics & abscess drained.child is asymptommatic.how do i proceed?? thanking you. Check Out the Answer

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