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Question :

Posted On : 28 Dec 2005

12 years old male presented to the casuality complaining of: fever,dry cough, S.O.B and swelling of the left face,neck and upper limb for 7 days PTA. O,E: finger clubbing grade 2, hepato splenomegaly, visible pulsations in the pericordium and suprasternal notch,tachycardia,tachypnea,stony dullness over the lower zones of the chest. Investigations done as follow: Hb Percent 9 gm, TWBC 15.000 mainly lymphocytes, ESR 115, RFT was normal, x-ray shows bilateral pleural effusion {moderate amount}, CT scan of the chest shows cystic bronchiectasis and basal bulle. Pleural fluid tap was hemorrhagic and it's analysis show: proteins : 4.5 g,dl, sugar : 56 g,dl, cells : lymphocytosis. Mantoux test was negative. Sputum for acid fast bacilli was negative. Echocardiography done and was normal. Rx : patient received I.V ceftrixone and ampiclox for 2 weeks and now he is on Ampiclox and Cefixime capsules. Please help us to reach a spot diagnosis and proper management.

Expert Answer :

No expert answer available.

Answer Discussion :

P

pediatriconcall

Rule out autoimmune disorder and malignancy. Do ANA, dsDNA, C3 and pleural fluid for cytospin. What is the LFT? Also are there any lymphnodes?

19 years ago

H

hamza

Lymphoma

19 years ago

D

Dr Jaiprakash

loculated abscess

19 years ago

T

Todd Chang

alpha one antitrypsin deficiency

19 years ago

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