Question of the Week

Question :

Posted On : 07 Dec 2005

11 year rajsthani female born of non-consanguious marriage presented with c,o-
1. abdominal pain since 20 days,tired on walking or accustomed work but no dyspnoea.
2. Vomiting -once every 2nd or 3rd day nonprojectile no relation to food.
3. Mild fever daily resolves after antibiotics.
All complaints since 20 days .
Father also noticed yellowness of eyes since 20 days. Child admitted to a hospital 10 days before. 2 blood transfusion were given.
O,E-pallor plus plus , icterus plus plus , vital stable , hepatomegaly 8cm firm regular surface, well defined edge, splenomegaly 5cm along axis, notch not felt soft, previous h,o of exactly similar c,o hospitalisation and transfusion 6 month back given 2transfusion at that time. In between absolutely symptom free . Please guide about differential diagnosis and diagnostic approach

Expert Answer :

No expert answer available.

Answer Discussion :

MANGESH DAMODAR KHANDAVE

Vomiting fever and clinicaly having jaundice all are indicator of viral hepatitis similar episode previously occured hence it can be reccurent hepatitis. It can be a case of chronic liver disease also.
Severe anaemia can occur in viral and other hepatitis but 2 similar episode both requiring transfusio n hemolytic condition like thallasemia intermedia or sickle cell anaemia to be ruled out.
HIV and chronic infection like malaria should be considerded

19 years ago

dr. sameer p. mhatre

Hereditary Spherocytosis

19 years ago

Pravin G. Patel

QUESTION NO3 Mild fever daily resolves after antibiotics,is difficult to understand, I think you mean antipyretics, Antibiotics control infection as unit. Antibiotics does not resolve fever on daily basis,Patient symptom free between 2 episode but what about signs{hepatospeenomegaly and pallor}in between two episode
ONE Recurrent Malaria needs to be considered and investigated{also do G-6PD},SECONDLY thalasemia profile is required to be done, Thirdly LFT and USG abdomen is required to rule out any Liver pathology

19 years ago

Najat