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A 16 month old boy presented with boil over scalp since 15 days, urticarial rash since 3 days and fever since 2 days. On examination, he was in shock and had hepatomegaly. He was diagnosed treated with IV Fluids, inotropes, Hydrocortisone (for urticaria) and Vancomycin and Ciprofloxacin to which he improved. His D-Dimers = > 10,000 units. Again after 1 week, he had similar urticarial rash with fever. At that time, there was no sepsis. Again D-Dimers = > 10,000 units. He was again treated with steroids and antibiotics to which he responded.

What is the diagnosis ?

Ira Shah

A 2 month old boy presented with jaundice without high coloured urine. He was on exclusive breast feeds and was immunized till date. On examination, he had jaundice without hepatosplenomegaly. Other systems were normal.

What is the diagnosis?

Read the entire teaching clinical query in the section of “TEACHING FILES” and try the correct answer.

Last month's teaching file: A 2 years old boy suspected to have dengue hemorrhagic fever with problems in fluid therapy. What is the problem? How should this child be managed now?


Answer: Fluid overload state.

BL Yatheesha, Ashwin Borade, L Rajam
Metabolic Syndrome in the at risk for overweight and overweight children and adolescents.

L H Bidari, Harsha B Patil, Praveen Shahapur
Myocarditis and Rickettsia Conorii Infection.

Titieni A, Ryan A
Pulsus Paradoxus in the neonate with respiratory distress.

Girija Mohan, Krishnan C, Sheeja Sugunan, Sathesh Kumar K
Dyke Davidoff Masson Syndrome (DDMS).

K Jagadishkumar

Skin lesions over scalp, posterior cervical lymphadenopathy, hepatosplenomegaly and seborrhoeic dermatitis. X ray of the skull revealed multiple punched out osteolytic lesions.



What is the diagnosis?

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