Question of the Week

Question :

Posted On : 10 Jul 2006

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 supra sternal notch,tachycardia,tachypnea,stony dullness over the lower zones of the chest. Investigations done as follow.. BFFM plus ve 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: protiens : 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.. Thank you for being patient with us..

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