Fever with jaundice

 
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A 7 years old boy presented with fever for 7 days and jaundice at onset of fever followed by generalized edema for past 3 days. He was admitted in a hospital for the same and diagnosed as enteric fever in view of Widal titre of 1:240 (both O & H) and treated with IV antibiotics but did not respond. On examination, he was malnourished (weight = 19 kg, height = 117 cm), had edema and hepatomegaly. Other systems were normal. Investigations showed :
• Hemoglobin = 7.7 gm%, WBC = 7,600/cumm [58% polymorphs, 42% lymphocytes], platelets = 4,90,000/cumm.
• Bilirubin = 0.8 mg/dl, SGOT = 113 IU/L, SGPT = 95 IU/L, Total proteins = 5.9 gm/dl, Albumin = 2.1 gm/dl, alkaline phosphatase = 1538 IU/L.
• HBsAg, HIV = Negative
• USG Abdomen = Hepatosplenomegaly with small granuloma in lower pole of spleen.
• Leptospira tridot = Negative
• IgG = 1470 mg/dl (Normal = 971-1746 mg/dl), IgA = 258 mg/dl (Normal = 75-178 mg/dl), IgM = 277 mg/dl (Normal = 66-153 mg/dl).
• CT abdomen = Few mesenteric lymphnodes, Spleen normal
• Blood culture = No growth
• Brucella IgM & IgG = Negative

Expert Opinion :
He was detected to be Hepatitis A infected.
Answer Discussion :
C
Carl Lambert
bubble
consider TB
1 year ago
TB or malaria
1 year ago

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