19 yr old female pt. comes with evening time severe nausea for 20 day then it get relieved itself after 20 days..pt also gives history of cough and fever for 7 days ..pt also gives history of pain abdomen at different locations mild in intensity..pt also gives history of weight loss...no history of blood in stools or malena ...on examination pallor is present ..abdomen examination is normal.. on USG inflammed terminal ileum is seen ..report is enclosed within
The patient is of 19 yrs F with nausea , weight loss and anaemia with vague abdominal pain without Malena and blood in stool . The pt has feature of cough and fever. USG says ileitis. Suggests immune deficient condition and may be due to tuberculosis, Type 1 DM and least chance of HIV infection. Crohn's disease is less common in female so less chance. For Tuberculosis CBC, ESR , s alkaline phosphatase, X-Ray chest to be advised. Also do plasma glucose.
young pt short h/o fever cough think of viral disease /mesentric adinitis again viral etio symtomatic treatment if symptoms persist get ct abdomen pain abdomen was there on and off for long period need to r/o appendicular pathology/ tb/molrotation may require colonosvopy/ gastroscopy
its a case of typhilitis with nonspecific enteritis. terminal ileum inflammation with regional lymphadenitis is the characteristic of this disease. pt presented with nausea probably due to sub acute intestinal obstruction or passable terminal ileal stricture. it can be managed by broad spectrum antibiotic with anaerobes covering(ceftriaxone with metronidazole and antispamodic). repeat usg after 4wk..if pathology subsides its well n good otherwise go fo cect abdomen and usg guided FNAC of mesentric lymph nodes.
In some viral or bacterial infection upper respiratory tract infection mesenteric lymph node are inflammed.They also subside with upperrespiratoryinfection subsides
Entrities collitiees infametray diseses do cbc urine r esr it may chrons ibs ibd so treat as ibd first also anamia may be there give iron supplement vibact viztylac antobitic orndazole deworm pan d then do other investogation if not subsides
do cxr and mantoux..terminal ileitis typhoid and tb to be suspected..since she got cough and fever ,dull aching pain and weight loss possibility tuberculous abdomen is high..if possible do a lap mesentric node sampling if other inv are non contributory
elietis or tiphlitis after stricturing or obstruction.start bactericidal like Rifabact and do TB GOLD.
It can be chron's. A colonoscopy can rule this out. Though no mesenteric lymph nodes are enlarged a C.T can also be done to rule out mesentric adenitis as the symptoms also suggests of kochs abdomen
X ray chest, ESR, CBC,Widal, LFT required to make diagnosis. Also want to know whether patient has any diarrhoea
evaluate for tuberculosis. abdominal.advise haemogram,chest x-ray,and cect .
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