Anemia with ?Abdominal infection

A 16 year old female presented to OPD with complaints of vertigo, headache, abdominal discomfort, breathlessness sometimes from last 1 or 2 months Chief Complaints Already been to several doctors but no relief Investigations TLC - 16400/mm3 Hb - 7.3 MCV is normal RDW-CV mild high She is willing to undergo further tests so advised her - Stool for RE VIT B12 IRON STUDIES CRP Management Treatment that I have planned for her is - Tab Zentel 400mg H/S stat dose, Tab Folvite 5mg once daily, Tab Zinconia 50mg once daily, Tab Limcee 500mg BD, Tab Cefolac-O BD, Inj Imiferon-s 2 ampoules in 100ml NS over 25 mins, alternate days, Today and day after tmrw Kindly guide me to locate the foci of infection if any as evident by raised TLC

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? ANEMIA WITH.. LEUKOCYTOSIS .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. URINE ROUTINE..C AND S .. EXAMINATION.. STOOL EXAMINATION.. CAPSULE ENDOSCOPY .. CXR .. KUB .. USG..ABDOMEN.. MEANWHILE TREAT.. SYMPTOMATICALLY..WITH.. IV..FLUIDS.. INJECTION CEFTRIAXONE 1GM.. POLYBION.. INFERON .. SYMPTOMATIC T/T..

Raised WBC count indicate bacterial infection It is important to identify the source of infection X Ray chest USG abdomen Urine routine and microscopy Investigations directed to find source of infection

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Leucocytosis indicate sepsis to be examined Xray chest Usg abdomen Pt is anaemic is it nutritional deficiency or bcz of infective aetiology Yes you can continue multivitamins supplements and iron therapy Put pt on iv fluids Inj Ceftriaxozone Inj meteronidazole In piperacillin+inj tazobactum

Sir the elevated TC points towards a bacterial infection.Foci is definitely confusing due to history. Kindly do a Urine Routine, Chest X-ray and peripheral smear. She can also be planned for a USG abdomen & pelvis.Menstrual history could give a clue regarding cause for anaemia which in turn would explain the vertigo. Most probably UTI would be the cause for the raised TC. Rest could be due to Generalised Anxiety.

Sir ,Thank you for suggesting and sharing the case. Multiple d/d , going by the history and labs seems likely to be autoimmune disorder . Elevated WBC is likely associated with infection , malignancy , systemic JIA and vasculitis. Anaemia can be non specific .. Kindly evaluate in detail about other findings on physical examination ... May need chest x-ray , USG abdomen , MRI brain ( to rule out vasculitis), ANA, ESR, ALT ,AST , CPK , LDH , urinalysis , RFT....

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Ad. Gi endoscopy. Kub. cxr. Usg study abdomen. Urine routine can s examination.

It looks more like a case of anemia Get history regarding her bladder and bowel habits Get an USG done if any findings seen on abdominal palpation

Def the TC is raised,so infection is there,also anaemic,Has an USG pelvis and abd been done,Are her pds normal,have you ruled out imperforate hymen

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