49 yrs male with no h/o any major illness,refered from other hospital and was diagnosed as PUO with THROMBOCYTOPENIA.c/o fever {on and off}. to rule out cause of fever we done CBC.LFT,RFT,HIV,HBSAG,HCV,CXR,URINE,USG ABDOMEN,CT CHEST,DENGUE ,LEPTO,MP,WIDAL.,ESR,MT.but no focus of any infection.tried all antibiotics like meropenem,lizolid,colistin etc.somehow platelets incresed.patient started persistent hiccups.usg s/o cholelithiasis.blood and urine culture normal.still fever is not subsiding.need ur suggestions.

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If everything like vitals and reports are WNL then wait and watch, ,no need to do Bone marrow aspiration and biopsy, ,fever will subside on its own in a span of some day's, ,,,diagnosis --?PUO with THROMBOCYTOPENIA

we are treating patient since 1 month.even he gets irritated with continuous fever.
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ps for mp done wat about mp antigen r u done tht? ?,,as thrombocytopenia is there put him on Artesunate 120 bid on starting day and then 60 mg b.i.d fr next 2 days, ,maintain TPR /BP /IO chart, ,periodic assessment of vitals especially temperature, ,

after artisunate and lariago administration for first 3 days platelets incresed gradually and now it is 3,00,000.my concern is fever 102* to 104*f with persistent hiccups .
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May be drug fever. better to observe the patient. record vitals timely and maintain input. output chart. .watch. try to rule out any malignancy. ..

drugs started to patient after 15 days of on and off fever.as he was taking pcm sos at home.
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It's due to cholecystitis, advised antibiotics, analgesics & after control, cholecystectomy.

maybe sir ....we are planning for mri upper abdomen with mrcp.
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well very extensive investigations. you have mentioned all in abbreviation form which I don't understand. is he on any medication . you have mentioned some very high powered antibiotics without My sensitivity test is dangerous. my advise will be to stop all medication and review. not as a money bag but a human being.

look for vitB12 and vitD deficiency and also rule out malignancy

can vit b12 and d deficiency cause fever?
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Patient has received ample antibiotics and thrombocytopenia has resolved, what were the clinical signs on arrival? What was the TLC and DLC, were there any Band forms? Did we consider the possibility of sepsis? Is the patient a diabetic? What is the detailed USG report and LFTs

haematologist opinion is must in this case.could be a drug induced pyrexia

if pt. normally not having major complained then stop all antibiotics and wait and watchfull negligence.
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Do a Bone Marrow Study ( both aspiration nd biopsy) ...nd get a PS reporting done by pathologist ..nd yes look for any lymphadenopathy !!

rule out immunological cause of fever .....ANA. plan BM examination.

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