Concluded Case

Fever - unexplained

A 70 years old with history of fever since last 20 days . All investigations are normal Including RT - PCR , Salmonella typhi antibodies, urine - R/ E Only in CBC - TLC - was 17000 for which he have received antibiotics . Now fever has settled but a peak of 99 - 100 °F is there . USG is also normal Although X - ray is also normal . But comment on right dome of diaphragm is welcomed

(Edited)

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Concluded answer

Fever with raised WBC count indicates bacterial infection with unknown source X ray chest is apparently normal Slight hump in right dome of diaphragm can be normal variation in addition in this case USG abdomen is not showing liver or subdiaphragmatic pathology

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Fever with raised WBC count indicates bacterial infection with unknown source X ray chest is apparently normal Slight hump in right dome of diaphragm can be normal variation in addition in this case USG abdomen is not showing liver or subdiaphragmatic pathology

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Case if PUO. Adv blood and urine culture sensitivity test. PCT, lactate level. HIV Autoimmune conditions Lastly malignancy. Need to step up antibiotics to narrow spectrum as per sensitivity test.

Yes it is bumping of rt dome with fibrotic strands in lung fields Though rt pcr said to be negative and there is leucocytosis this only suggest covid19 pneumonitis with lung fibrosis as dome is pulled and bumping Leucocytosis is secondary infection Xrays are post covid followup Better go for hrct and covid lab parameters

* PYREXIA.. * LEUKOCYTOSIS.. * RT..PCR..COVID.. NEGATIVE.. * CXR..STUDY.. NORMAL.. NEED'S.. BS..ANTIBIOTICS.. WITH..ANTIPYRETIC..PCM..

Humping of right dome of diaphragm , and leucocytosis are the positive findings in this 70 year old man with PUO. Suggest Blood and urine culture Look for lymphnodes , if relevant, biopsy CT abdomen and Chest Repeat RTPCR for COVID Inflammatory markers, D Dimer Look for malignancy , mostly clinical exam and history for possible system location.

Normal

Amoebic liver abscess

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