Question of the Week

Question :
Posted On : 07 Jan 2024
A case of 13-year-old female child was admitted with c, o fever for 90 days, and jaundice for 45 days. No other complaints. Systemic examination normal(no hsmegaly).investigation sgot sgpt normal alk po 4 normal, s.bilirubin 5.4 (direct 3.2), s.albumin 2.2, s globulin 5.0, WBC count normal, platelets on higher side,esr 150, hb 9 mg, dl, ldh normal,s ferritin 690(high)crp positive(40), mp not seen, mauntox test negative, USG abdomen normal, ct scan abdomen normal, HIV, HBsAg, HCV negative, ana negative, anti lkm type 1 antibody negative. widal positive before 2 months now titers are normal,tb igm low positive (1.1)tb igg normal, blood culture no growth, stool culture no growth, liver biopsy report awaited. Till date treated with different antibiotics along with a hepatoprotective drug but still fever continues (daily 2 spikes of 100f )with high total and direct bilirubin. Looking sick but not toxic, weight loss with good appetite. What is the possibility?
5
Expert Answer :
Rule out kalazar and sclerosing cholangitis. An MRCP would be useful. Is the stool clay coloured? Since ESR is high and platelets are also high, autoimmune sclerosing cholangitis should be ruled out.
Answer Discussion :
A
Adão Couto
Profile
.....
1 month ago
D
DrZohdi Alhanouty
Profile
Leptospirosis,other spirochetal diseases
1 month ago
M
Mohammed Alhemiary
Profile
is it a subtype of Rheumatoid arthritis
PBC
Paraneoplastic syndrome of vanishing bile ducts..Brucellosis, typhoid

1 month ago
A
amneh issa
Profile
Given the presented symptoms and investigations, it’s essential to consider various possibilities. The prolonged fever, jaundice, and elevated bilirubin levels warrant a thorough evaluation. Differential diagnoses may include infectious causes like atypical infections, autoimmune hepatitis, metabolic disorders, or infiltrative liver diseases.
1 month ago
D
Daniel Aporo
Profile
Leishmaniasis ?
1 month ago




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