50 yrs f presenting cough with sob,fever, anorexia since 3 months,Widal, kala azar positive,esr 101, anemia++

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This patient is having severe anemia....this Leishmaniasis Kit test is not dat specific in endemic areas...It remains positive even after the disease is cured....The hallmark of Visceral Leishmaniasis is Splenomegaly plus minus hepatomegaly...Whether that is present...Patient belings to which area....Also Do Typhidot IgM and clinical features correlation...What is the duration of fever...PRBC transfusion is required.... No IV fluid is given at such a fast rate in severe Anemia due to risk of precipitation of High Output Heart Failure...Treat patient in the best possible way after coming to the specific diagnosis....

Treat Anaemia with blood transfusion Check for hepatosplenomegaly Treat accordingly
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Chest x-ray.. Scalloped right dome of diaphragm. Left dome of diaphragm elevated due to gas distended splenic flexor of colon. Unfolding of Aorta. Both lungfields are clear.

Sob is due to anemia which is not looking chronic ,so satrt fluid 100 ml/hr, keep spo2 above 94, optineuron in dextrose , cross match 2 prbc n transfuse then in one day another next day to avoid fluid overload , Cap Miltefosin 50 mg bd for 3 weeks it is the drug of choice with practicaly no side effects, start formula feed with kitchen feed slowly initially 50ml 1hrly then gradually increase to 100

Typhoid &uti

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