18y/M having on-off high grade fever with chills and rigors..pain in abdomen and chest(non-cardiac origin) yellowish discoloration of sclera and B/L pedal edema since 15 days. pt experiences pain even during auscultation of chest which revealed no cardiac abnormality but crackles+crepts heard over rt basal lung zones... on admission vitals were T-101°F P-120/min R-30/min BP-90systolic (initially no diastolic BP was perceived...but after 3 days in M-ICU NO was 90/40) SpO2-90%on RA and 96% on O2 @ 4L/min Pt is basically from bihar



Two seperate things are present here... Chronic illness i.e. Typhoid probably causing Typhilitis as evident from ileocaecal junction thickening causing occult blood loss leading to anemia....hypoalbuminemia leading to pedal edema Secondly this pt is having Consolidation in right lung base which can be Pneumonitis leading to respiratory failure plus sepsis... Both have to be treated independently

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Case of sepsis~MODS, DIC with sepsis induced thrombocytopenia. With polyserositis .......d/d ...malaria , leptospirosis or enteric fever with sepsis

Typhoid n it's compilations

It's a case of typhoid.

Tyhpoid fever with it's complication....but leptospirosis should also be ruled out... another one possibility of rickeettsial fever also.

Could be malaria

MP is neg

Complicated typhoid fever D/D Lepto Q fever Rickettsial fever Abd koch’s

Can be typhoid Can be leptospirosis Can be tuberculosis Has to do hiv test also. What about renal parameters?? Can advice lymph nodes biopsy and colonoscopy as he is young, in shock and has multi organ dysfunction , so has to be investigated thoroughly and aggressively

In one report ser creatinine was high with deranged LFT: Patient is from Surat: think of Leptospirosis & investigate/ treat accordingly Surat once had epidemic of plaugue

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