35 yrs f presenting fever, cough with sob, malaise, anorexia since 2-3 months, was taking medicine from the pharmacy,no benefit h/o ptb in 2011,ASO TITRE RAISED weight 34 kg, sharing reports pls suggest ur valuable opinions

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Performa History of weight loss Pattern of fever Progression of SOB Pulse rate BP RR Spo2 JVP Pedal edema Puffiness of eyes Rhonchi or crepts on resp exam Any rash Hemoptysis Hematemesis CBC KFT LFT Blood culture Urine culture Sputum for gram, ZN stain and fungal KOH Preparation USG Abdomen.

There are called modified John's criteria for diagnosis of rheumatic fever It includes symptomatology and investigation There ASO is considered as minor criterion Suspect a Rheumatic fever on the basis of history and symptoms first

Agreed Sir. Specially the LUZ show only dense Fibrotic lesions with hilum pulled upwards, indicting sequel of Old Disease. Any fresh activity for TB can be ruled out by Fresh Sputum analysis for AFB and CBNAAT.
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There are multiple nodular swellings in lt hilar and apical region p/h/o pul tb. Hemogram shows leucocytosis .polys 80% indicative of reactivation of pul tb with sec chest infaction send genex confirmation for mdr at the same time start broadspectrumantibiotics to cover chest infection

Needs TB ttment considering MDR TB Start nutrisios diet to increase wt Observe him and check for rh. Fever

35 YEARS OLD FEMALE WITH FEVER COUGH MALAISE ANOREXIA INVESTEGATE ON THE LINES OF TUBERCULOSIS LUNGD SPUTUM FIR AFB C TBSCAN CHEST COVID 19 TEST

Raised Aso becomes a important finding if throat swab culture show positive Streptococcus beta haemolyticus . urine is showing puscell ++ pl exclude UTI

Fibrocavitary lesions left upper lung. PTB.

Fibro cavitary lesion LUZ. Reactivation of old PTB. Sputum for AFB. If negative then do CBNAAT.

I have questions What was in your mind before sending ASP titre?

Dear sir,had recurrent fever and malaria, typhoid, kalazar negative,PR 110, so went for aso
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Bacterial endocarditis...

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