Posted On :
09 Apr 2011
I have a female patient,13 y old with prolonged fever 1 mo ago,delayed puberty,short stature,no HSM.Abdominal us shows chronic medical renal disease.Urine analysis shows only epithelial cells ,on hematuria,no pyurea.CT brain shows empty sella syvdrome.Levels of FSH,LH are within normal for age .CBC had normal values but neutrophils 72 percentof total WBCs.CT chest shows mediastinal lymphadenopathy.ESR 55,100 in 1st,2nd hours.LDH= 635u, l,-ve Widal,brucella tests.Fever was not controlled despite ttt by ampicillin-cefotax for 2 weeks,no other systemic manifestations .What is your differerntial diagnosis,what other needed investigations_?
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