12 yrs boy had fever 8 days back which lasted for two days, generalised weakness since then was afebrile, now again fever, pain in abdomen from two days o/e febrile, abd vague tenderness, liver 1 cm ,BP normal sugest dx &Rx pl.

(Edited)

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Dear Dr narender Ultrasound findings suggest of two causes Viral etiology Enteric colitis Give symptomatic treatment he would be fine on line of enteric fever Yes you must rule out dengue classical and malaria too

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Gradually increasing fever over period of 1 week Pain in Abdomen Palpable liver/spleen Anemia in CBC Normal SGPT, U & C Urine R few pus cells, +albumin USG e/o hepatosplenomegaly, edema & inflammation of small nd large bowel. Dd Enteric fever IMN Urosepsis G -ve septicemia Plz do CRP, Blood & Urine culture, widal test, x-chest Rx Hospitalisation IVF iv Ceftriaxone Proceed as per results of further investigation. Plz update

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Work up with LIVER ENZYMES STUDIES. VIRAL MARKETRS. SMEAR FOR M.P. BLOOD CULTURE SENSITIVITY STUDIES. CXR, WEILS TEST. PLATELET COUNTS. DENGUE TESTS ESR, MX TEST. PERIPHERAL SMEAR FOR ABNORMAL CELLS. DX : PYREXIA WITH HEPATO-SPLENOMEGALY FOR EVALUATION. D/D : ENTERIC FEVER. MALARIA. VIRAL INFECTIOUS ETIOLOGY. DENGUE-LIKE- INFECTIONS. RX : ACCORDINGLY.

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History of fever and afebrile period for 2_3 days and following fever with vague and pain gen weakness heptomegaly free fliud in the abd and edematous GB and anicteric hepatitis more likely 1. viral etiology dengue but thrombocytopenia not present looknfot rash and flushing and BP 2. Enteric fever can alsovbe possible 3. Leptospiral infection 4. Rikettsial infection. 5. Brucellosis

Seems like prodormal symptoms , suggestive of viral hepatitis... Do LFT, Viral markers ( A B C D)...

Older child with fever on and off with abdominal pain with usg suggestive of UB thickening and mesenteric lymphadenopathy look like campylobacter infection or H pylori infection or any viral infection give rise to this manifestation

History and lab findings s/o enteric fever R/o dengue Viral hepatitis

What is intensity of fever? Was child afebrile in between aatacks of fever or was on antipyretics? Any relevant past history?

Afebrile in between High grade fever
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Entric fever Viral Hepetitis

Acute fulminating hepatitis

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