Concluded Case

5yrs old male child came with c/o bleeding from rt ear and nose after fall during play. O/E minimal bleed from nose and rt ear. many perpuritic and ecchymotic patches over body. more on forearms and face on right side. boy is otherwise healthy concious oriented active and playful; have no fever cough cold in recent 4 to 5 days. ? neither have h/o the same in last 2 to 3 weeks as per mother. he inverstigated for the same by some general practitioner cbc 6.8/7500/20.000 other routine tests are normal including BT, CT and PT INR and dengue profile. differentials.

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Concluded answer

Its a case of ITP. Managed conservatively. as symptoms reduced.

All Answers

Though Case LOOKS LIKE THROMBOCYTOPENIA, AS PER THE INVESTIGATIONS. STILL NEEDS BRAIN C.T. SCAN. ENT SPECIALIST EVALUATION. TO R/O : INTRACRANIAL BLEED. IF NEEDED GO FOR BONE MARROW BIOPSY TO R/O MAJOR CAUSES OF THROMBOCYTOPENIA. DX : THROMBOCYTOPENIA. RX : ACCORDINGLY.

There is swelling below rt ear. Tonsils are normal in size and shape. ?cervical LN.

CT Head should b done. Workup to look fr DIC, ITP etc..

DIC very unlikely
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DR RAHUL TWO DIFFERENT THINGS ARE HERE I THINK NO CONCERN OF HEAD INJURY TO THIS ECHYMOSIS AS YOU EVALUATED WELL AND NO HISTORY OF FEVER SO CHANCES OF ITP IS VERY REMOTE DX DIC OR PREVIOUS HEMOLYTIC DISORDER LIKE G6PD ENZYME DEFICIENCY AND CLOTTING FACTORS 8AND 9 ASSAY OTHER IS ABDOMINAL BLEED EITHER SPLEEN OR LIVER MILD CONTUSION MUST BE KEPT IN MIND RX REGULAR MONITORING OF PLATLET CT BT AND BP VITALS MONITOR SYMPTOMATIC TREATMENT INVESTIGATION ADVICE CT HEAD CT ABDOMEN

Agree with you sir. But fever in case of ITP is not essential for diagnosis. Isnt it?
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Malignancy?? Wat about peripheral smear?

Wat about splenomegaly

Forgot to mention. No hepatosplenomegaly.
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There bicytopenia r/oHLH too

Immune thromocytic purpura

Steroid or IVIG r treatment of choice
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