Question of the Week

Question :
Posted On : 07 Jun 2017
i have one patient 5 yrs old male child weighting 17 kg c, o pain in lower limb {muscular} 20 days, backache since 10 days , pain in abdomen generalised since 5 days, decreased apetite, fever low grade since 5 days, now c, o pain in left thigh .on examination vitals normal no rash no generalised lymphadenopathy , no hepatosplenomegaly, investigations are
hb 9, tlc 9000, plt 3.2lakh, esr 107, mp negative
mountox test negative
usg abdomen s, o minimal free fluid,mesentric lymphadenopathy, bowel wall oedema,
ra factor negative, crp 13 which is positive
lft and rft normal
x ray chest and both hip joints normal
kindly give your opinion for management
Expert Answer :
what about X ray doral and LS spine_?, if not then an Mri.HIGLY SUGGESTIVE OF AN INFECTIVE SPINE LESION. i would also rule out salmonella, one of the DD`s also could be rapidly progessing aggressive epidural tumour.
Answer Discussion :
L karpagam
elevated esr and positive crp ongoing inflammation so treat iv antiinflammatory it could be viral myositis socan do cpk
4 years ago
Intestinal tuberculosis
4 years ago
Rashid khan
typhoid fever do thypidot IgM
4 years ago
Ibrahim Ghazi
I think he may need I.v. antibiotics and follow up , further work up like brucellosis agglutination test , CT abdomen and bone marrow exam .
4 years ago
salma faroug
need widal test for brucellosis
4 years ago

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