Fever, Leukopenia with History of Mosquito Bites

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Can I use this site to request help with a differential for an I.D. problem? If so, here is the presentation: 18 year old black female with 3-4 days of fever 102-103, myalgias arms and legs, headache without meningismus, although h/a with motion of head and her eyes; she has NO rash, menses occurring, She had been to the Caribbean one week earlier for an overnight with family in Jamaica, NO hx tic bite; maybe one or two mosquito bites, sweats and chills at night 1-2 nights. No real cough of any significance. Mom with history of colitis (u.c.), and lupus. PExam notable: not toxic, although she is ill with malaise. Moderate upper lid has edema without erythema or tenderness. No other visible edema is noted. Small residual induration present without pain or erythema at upper gluteal cleft. She is on the last day of Bactrim for treatment of a pilonidal cust infection. It looks good and appears to be a red herring. Lab: WBC 2.5 (leukopenia), nl diff, nl h/h; u/a +3 blood but MENSES; neg protein. CRP, Sed RAte, Blood culture, CMP pending. Your thoughts???? Thanks, Marc Tanenbaum, MD Atlanta, GA
Answer
Since she has fever, leukopenia with history of mosquito bites, rule out dengue and malaria(if it is common in Jamaica). Further thoughts can be only after CBC report (Hb, platelets and whether leukopenia is improving or not). Back to All Questions

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