8yr/M having fever for last 1 month with temp 102, with mild pain in abdomen and constipation on/off. No history of rash/bone pain Typhoid/dengue/Malaria all negative CXR normal Usg- mild dialated loop Blood culture is normal Blood rep- High TLC with Inc CRP Treatment given Pcm azithro cefixime and amikacin Pateint has temp 99 but tlc is high. What can all be cause and what is the diagnosis and treatment approach.

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Enlargement of mesentric lymphadenitis on USG is in favour of non specific mesentric lymphadenitis, Tubercular mesentric lymphadenitis or as part of enteric fever

abdominal kochs. may give temporary improvement if patient is on amikacin due to its anti tubercular activity. adv ct abdomen

you can go for cefixime in enteric dose if complaints are reduced. if complaints recurr again after stoping rx then for sure go for ct.
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Tuberculosis to be ruled out by MX test..102 spike of fever continuing for 1 month is suggestive of doing a LP... blood culture sensitivity should be done and preferred higher antibiotics should be started....

're evaluate the case.. proper history.. and treatment history
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rule out enteric fever dd kochs abdomen

Reports are nit clearly seen in pics .... Do peripheral blood smear 2D echo CECT abdomen for LN and pathology Do ESR....

Abdominal USG has not shown any features of abd kochs, so less chance. Rule out enteric fever again. Get an urine examination done to r/o UTI

d/d kochs, enteric ,uti reevaluate

Maybe tuberculosis?check once montox test and TB gold

Mesentric lymphadenitis.tt symptomatic with higher antibiotics

R/l out Abdominal TB

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