Concluded Case

A CASE OF FUO

16 F FEVER = SINCE 27 - 3 - 2020 LOW GRADE MOSTLY AFTER NOON NIGHT COUGH 0 SOB 0 URINARY SYMPTOM 0 MENSTRUATION ( N ) WKNESS + APPETITE - LOW PAST ILLNESS = LT CERVICAL LN + BIOPSY = REPORT NOT WITH PT FATHER SAYS IT WAS NORMAL NO H/O ATT O/ E DOES NOT LOOK THAT SICK PALLOR + BP 86 / 50 LIVER + SPLEEN + LYMPHADENOPATHY = RT POST /\ + LT ANT /\+ POST /\+ RT AXILLARY+ SIGNIFICANT INGUINAL BOTH SIDES++ CHEST = NAD POSSIBLY SOME MOVEMENT IS DIMINISHED LT SIDE NECK RIGIDITY ------------------- TLC DLC ( N ) ESR = NOT DONE CXR = POSTED URINE 3- 5 PUS CELL/ HPF CULTURE NO GROWTH INVESTIGATIONS PLANNED 1 DUE TO LOCK DOWN L NODE BIOPSY COULD NOT BE ARRANGED ---------------------------------- ONE LAB AGREED FNAC L NODES 2 BLOOD ESR PLASMA CORTISOL EBV PCR 3 MANTOUX TEST 4 USG ABD FOR L NODES 5 REPEAT CXR -------------------------------------------- D = POSSIBLY TUBERCULAR LYMPH ADENOPATHY DD = EBV INF = INFECTIVE MONONEUCLEOSIS LYMPHOMA

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Concluded answer
I POSTED FOLLOW UP OF THIS PT LYMPHNODE BIOPSY COULD NOT BE ARRANGED AT LOCK DOWN PERIOD FNAC OF RT AXILLARY WAS FAULTY POSSIBLY DOCTOR WHO DID IT COULD NOT PALPATE THE LYMPH NODE & IN OTHER AREAS IT WAS NOT TRIED REPORT OF FNAC WAS SENT TO MY WHATS APP BY HER FATHER ( WHICH I POSTED IN FOLLOW UP - REPORTED AS FATTY TISSUE PT HAS BEEN ADMITTED AT LOCAL NURSING HOME I AM NOT BEEN INFORMED PRESENT STATUS OF THE PT I SHALL INFORM YOU IF I GET ANY REPORT FROM HER FATHER
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I POSTED FOLLOW UP OF THIS PT LYMPHNODE BIOPSY COULD NOT BE ARRANGED AT LOCK DOWN PERIOD FNAC OF RT AXILLARY WAS FAULTY POSSIBLY DOCTOR WHO DID IT COULD NOT PALPATE THE LYMPH NODE & IN OTHER AREAS IT WAS NOT TRIED REPORT OF FNAC WAS SENT TO MY WHATS APP BY HER FATHER ( WHICH I POSTED IN FOLLOW UP - REPORTED AS FATTY TISSUE PT HAS BEEN ADMITTED AT LOCAL NURSING HOME I AM NOT BEEN INFORMED PRESENT STATUS OF THE PT I SHALL INFORM YOU IF I GET ANY REPORT FROM HER FATHER
Thank you for posting the case..it appears to me a case of lymphoma...lymphnode biopsy is required..I can arrange for same..at Kolkata!!
possibly lymphoma blood transfusion prednisolone 10 mg tid 7days wait for excision biopsy