i would be happy if some one helps in diagnosis of this problem. 13 yr old child presented to us with fever with chills recurrent episodes since her 9 yrs of age, every time requiring long duration of hospital stay. We got hepato splenomegaly(massive) and few temporary lymph nodes. every work up for malaria, dengue, UTI, Cholangitis came negative. Then we proceeded with work up for connective tissue disorders which is also negative. Bone Marrow showed Erythroid Hyperplasia. This time when she was admitted, she collapsed and went into picture of DIC. It was very difficult for us to revive her out of it. Brucella, Leishmaniasis work up was also negative. THe only positive report we got in the previous admission was TB PCR positivity in CSF.We started her empirically on ATT. We feel she has some immuno deficiency that makes her succumb to recurrent fatal infections. How ever her HIV Status was negative. Whole body gallium scan also showed nothing. At present she is out of ICU in the ward...... waiting for the next episode of infection. Can u help us in diagnosis? How to rule out immunodeficiency? We have sent samples for complement analysis and Immunoglobulin Electrophoresis and results are awaited. Work up of sarcoidosis is going on. What else to rule out?