7 yrs old male child with fever since 17 days on and off 101 to 103 with chills, mild cough. iv pipzo amikacin started 3 days back but still fever , hemodynamically stable . widal is nagative . plz give ur expert opinion.

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I think Needs the Further investigations Still Adv:- IgG IgM,NS1 Dengue. Widal LFT Usg abd/X-ray SOS. Meanwhile treat Symptomatically Rx. Tab.Mahaceff plus 1/2 bd. Tab.Calpol 250 mg TDS Becosule syp 5 ml OD. Cough syp.Symptomatically Inj.Monoceff 750 bd. Inj.Amikacin 250 mg. IV fluid SOS

Investigation is required properly. Hb.CBC, widal, LFT, dengue serology, urine culture and complete, USG abdomen , X-ray Chest. Stop all antibiotics, only antipyretic,plenty of fluids. Treatment according to cause.

Look for pneumonia,throat,otitis,most probably secondery to viral fever,5 days of parentral antibiotic what you started with should take care,if not go for blood culture,usg abdomen,urine rt/culture,x ray chest.

fever beyond 2weeks,possibility of infection(typhoid,leptospira,typhus,tuberculosis), granulomatous disease (Kawasaki though not common in this age group,connective tissue disorders and thirdly malignancy,

Respected sir / madam agree with ur valuable comments . thanks USG :- WNL , X ray chest :- LRTI. i have 4 pts since last 4 months with same picture , previous 3 pts tooks 21 days - 24 days to subside fever . is it viral ? or ?

What was the treatment given to the previous patients...??
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IN A CASE OF FEVER ( LASTING FOR 7 DAYS) 1 CLINICAL EXAM TO ARRIVE AT A POSSIBLE DIAGNOSIS 2 BEFORE STARTING AN ANTIBIOTIC SEND BLOOD FOR C& S CRP / PROCALCITONIN LFT CREATININE 3 URINE C &S -------------------------- PL MAKE A PROBABLE DIAGNOSIS & CHOOSE ANTIBIOTIC FOR THAT --------------------- ONE ANTIBIOTIC AT A TIME WEIGHT FOR AT LEAST 5 DAYS TO SEE IT ACTS OR NOT ---------------------- BY THIS TIME= REPORTS OF C& S WILL BE AVAILABLE & GUIDE US ---------------------------- CXR USG CT SCAN & OTHER BLOOD TESTS NEEDED CAN BE DONE WHILE ON TREATMENT ----------------------- LOOK FOR DRUG FEVER CLUE= RAISED EOSINOPHIL COUNT STOPPING DRUGS FOR 48 HRS STOP TEMP ------------------------- I FEEL = NOT TO STICK TO WIDAL SEND BLOOD C& S

I would suggest blood culture,chest xray and abdominal usg as the next line of investigations.Serum procalcitonin would be helpful to differentiate whether the increased WC is due to infection or inflammatory.

sir, how does serum procalcitonin helps to differentiate infection from inflammation
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Leucocytosis do xray chest usg abdomen case of fuo do fever profile

Further investigations required: X ray chest, urine c/s, Dengue serology, Typhoon IgG IgM, OptiMal or MP by Card, CRP, and if possible Procalcitonin

rule out koch.inf. adv.cbc,mp.,pletlets. blood smear,xray chest

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