Diagnostic Dilemma


An 8 years old girl presented with recurrent fever for past 1 month. She had an exanthematous rash 2 months ago along with fever that subsided in 3 days. Now she has fever with chills and rigors for one week. There is no cough, vomiting, bladder or bowel complaints. On examination, she had soft hepatomegaly. Other systems were normal. Investigations showed:

• Hemoglobin = 11.4 gm, dl
• WBC count = 6,900, cumm
• Platelet count = 3,52,000, cumm
• ESR = 40 mm at end of 1 hour
• Urine routine and culture = Negative
• Liver function tests = Normal
• S. creatinine = 0.8 mg, dl
• Widal test = Negative
• Stool = Normal
• USG Abdomen = Bilateral pleural effusion with ascitis and gall bladder wall thickening.
• Dengue IgM = 1.55 AI { More than 1.1 = Positive}, Dengue IgG = Negative
• OptiMAL for malaria = Negative

She was treated with Ceftriaxone and Amikacin for 7 days to which fever responded.

Is this child having Dengue hemorrhagic fever_?
Answer Discussion :
Enteric fever
9 years ago
anil ram
no. recurrent fever and one month duration rules out dengue
9 years ago

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