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Question
Dear pediatrics on call, i have a child with the following symptomatology- fever past 7 days, dysentry and now melena past 4 days, altered sensorium, thrombocytopenia, mild azotemia, grossly deranged LFT'S, peripheral smear could not be sent pre BT, normal CSF examination and electrolytes. He has a noraml urine output so far. PT PTTK MILDLY DERNAGED. Till now has received 2 bt's , one PRP,IV ANTIBIOTICS. Could it be TTP( throbotic thrombocytopenic purpura) But the liver derangement does'nt explain it. Please give me few alternate diagnoses?

Answer
What is the urine test and renal function tests. Rule out Dengue, Leptospira, Malaria and DIC. HUS is a possibility if there is hematuria or renal failure.
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