A young male 25 yrs of age visited Mumbai and developed high grade fever a/w chills for 2-3 days f/b gradual yellow discoloration of eyes and urine and showed to us and got admitted...There was no history of any drug intake or comorbidity.....He was found to have deranged KFT also.....Comment on the treatment approach and the probable Etiology



Sudden onset of fever with chills and rigor with yellowish discoloration of conjuctiva . His kfts are heavily deranged and hemogram shows leucocytosis with thrombocytopenia you have not given lfts and electrolytes so also urine out put what about past illness if any and wether he is alcoholic. D/d viral hepatiti B or E 2 leptospirosis 3 denguefever with hepatorenal failure

Thanx dr Vedprakash Sharma

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Viral hemorrhagic fever likely eg Leptospirosis....involving Liver and kidney with severe thrombocytopenia... Other possibilities are Dengue, malaria, Hep E, Severe sepsis with shock etc... Do USG abdomen, Dengue amd Leptospirosis IgM, HAV amd HEV IgM, Malarial parasite ...

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Hepatorenal syndrome,setup falciparum malaria, leptospirosis,various hepatitis virus,(band c virus hepatitis and glomerulonephritis) sepsis complicating infections, investigation of all these infections and treat accordingly

Hepatorenal..most likely leptospirosis.. Enymes? Hepatic coma regimen to be included Adequate hydration If anuric..HD Platelet transfusion Watch out for shock ..DIC Vit K Antibiotics..ceftriaxone..doxy

Hepatitis-E or Leptospirosis Kindly do Viral marker serology and spot UPC Ratio to find the primary cause(hepatic/renal) Further management according to the reports being followed

Tropical fever syndrome..... could be leptospirosis/typhus fever/malaria.... you didn't mention about CBC... What was the Hb and platelet count?... I would start on empirical ceftriaxone and doxycycline, pending investigations

CBC is given.....kindly hv a look

Pt has lfts, RFTs suggestive of hepato renal syndrome but since it's acute rule out leptospirosis, viral fulminant hepatitis with renal affection, septicemia , check cpk .

Do an usg abdomen.Bilirubin is grossly raised with symptoms of fever with chills and gradually developing jaundice.May be cholangitis with Acute kidney injury

Leptospirosis S.electrolyte Cefriaxone with doxy If needed dialysis

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