Concluded Case

A case of 25 yrs male with c/o fever since one day and temperature was 103 - 104 No other complaints, now he is having temperature 103 - 104 even after giving paracetamol. His NS1 n Igm igg is negative. Please diagnosis and management.

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Concluded answer

possibilities are many.. Get MP by smear as well as Pf / Pv antigen done to rule out or confirm Malaria. since Dengue NS1 Antigen is Negative possibility of other Arboviral diseases can be another possibility. if severe Arthralgia plan Chikungunya serology testing. If associated with altered LFT then you can even plan Leptospira testing. certain atypical Viral syndromes has to be kept in mind. Mean time u need to maintain good Hydration. Anti Pyretics n cold tepid sponging n supportive treatment. Avoid NSAIDs like Diclo Nimesulide etc. Definitive treatment as per investigation results. Regards.

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possibilities are many.. Get MP by smear as well as Pf / Pv antigen done to rule out or confirm Malaria. since Dengue NS1 Antigen is Negative possibility of other Arboviral diseases can be another possibility. if severe Arthralgia plan Chikungunya serology testing. If associated with altered LFT then you can even plan Leptospira testing. certain atypical Viral syndromes has to be kept in mind. Mean time u need to maintain good Hydration. Anti Pyretics n cold tepid sponging n supportive treatment. Avoid NSAIDs like Diclo Nimesulide etc. Definitive treatment as per investigation results. Regards.

his MP negative widal negative WBC and Platelets is gradually decreasing
0

possibilities of dengue like Arbo viral syndrome is more likely. Get LFT. whether there's any serositis look for USG Abdomen. Look for Lymphnodes, organomegaly n Arthralgia if associated.

agree with Dr. V Patel line of treatment first treat thrombocytopenia,vigilant for hemorrhage from occult sites , treatment Blood/platelets transfusion,care and continues follow-ups
1

there are instances wherein though pts test negative for ns1 igG and igM ....they behave exactly like dengue fever ....keep a close watch on pcv and platelets ...if they show progressive haemoconcentration and thrombocytopenia ....it still may be dengue fever .....other dd would be eneteric malarial fever or brucellosis etc....

Thank you doctor
0

can be enteric fever, thus dengue should be kept in mind so also malaria. start hydrating, give oflox 200 bd, celin 500mg TDS, paracetamol, and PPI. Send rapid malaria. And send dengue NS1 on third day of fever.

Thank you doctor
0

Most viral fevers lead to leukopenia and thrombocytopenia. Rx Paracetamol 650 four times a day. Proper hydration. Light diet. If no improvement after five days, then repeat blood tests.

Low platelet count & wbc count with neutropenia suggests enteric fever aprat from Dengu lepto & for malarial infection should be investigated

Thank you doctor
0

pls do urine culture preferably./urine routine. most probably dx Viral maleria tt keep electrolite maintain. if pus cell/ rbc in urine found .add antimalerial and antibiotic. wth vit B12 in infusion. daily 5days.

Pancytopenia do typhi antigen repeat CBC after hr reduce 15000 pletelet per day then admit even bone marrow if needed

for thrombocytopenia you can start with Tcyte syrup 1 tsf thrice daily for 5 days or until the count rises. Tcyte syrup is good in increasing platelets

Thank you doctor
0

Viral, rule out malaria.

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