Fever with abdominal pain

4 year old female complaints of fever since last one week duration of fever reduced from eight hours to four hourly now associated with abdominal pain and body rash. Has taken paraxin nd on taxim o currently but fever at four hours intrvl n abdominal pain remains plz advise trtmnt n diagnosis As per all say urine reports done is normal USG done is normal ...

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Send urine-Rm and usg- abdominal.... Any physical examination signs like hepato/splenomegaly? Start inj. Ceftrioxone,oral Azithromycin,oral chloroquine... Dd Enteric fever(fever raising trend,abdo pain, diarrhoea,coated tongue) Malaria(high fever, mild Anemia, splenomegaly) Liver abcess (fever,right uppar quatrant pain or tenderness) Kawasaki disease(fever,irritable, congestion of lips ,tongue,conjunctiva,rash) Gall stones Intraabdominal infection Resolving dengue
Thank you doctor
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What's the weight of the patient. Esr is elevated n crp is positive. If definitely not a viral fever. U should have gone for widal test n urine r/e n c/s atleast. Start the patient on inj Montaz 75 mg/kg/day n azithromycin orally. Maintain hydration n other supportive treatment. Good luck. If they come negative go for Usg abdomen to look for any hidden focus of infection.
14 kg
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IT'S A..CASE OF.. ? VIRAL FEVER WITH.. UTI .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. URINE ROUTINE.. URINE C AND S EXAMINATION.. USG..ABDOMEN.. CXR .. MEANWHILE TREAT SYMPTOMATICALLY.. ANTIBIOTICS WITH ANTIPYRETIC..PCM ...AS PER REQUIREMENT .. PPI.. MEFTAL SPAS.. DEWORMING WITH ALBENDAZOLE.. GLUCOSE SUPPLEMENTS..
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Send blood culture..urine routine... Required usg abdomen Give inj ceftriaxone 100mg/kg/day along with azithromycin... Monitor temperature Kindly describe skin rash... You can give doxycyclin as per rickettsial endemic area....look for eschar
Sir it's erythematous type of rash on back and five spots on legs no eschar
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Adv urine routine and microscopy Sos culture. USG abd pelvis And cxray to see for active infection. CBC normal and CRP raised favours viral etiology.
Thanks
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ADVISABLE USG... WHOLE. ABDOMEN BLOOD. AND. URINE......C / S SYMPTOMATIC. TREATMENT. ...TILL. THEN..... ADD.... RABIPRAZOLE - DSR
Thanx @Dr. Dinesh Gupta Sir Ji
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Viral Fever , UTI Send Blood for CS , Urine CS, ESR is elevated do CXR P/A to rule out Pneumonitis, Do CRP, D dimmer, Serum ADA
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Need- Viral marker, USG ABDOMEN, blood CS, URINE CS / RM, FEMALE - ALWAYS RULE OUT UTI
Sir pt doesn't has any urinary complaints urine output and input is normal
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ESR and CRP is elevated with no significant change in WBC suggest there is inflammatory process going in body. Adv:- Blood culture Urine routine USG abd. & pelvis (as early as possible) CXR T/t:- Inj. Ceftraczone 100mg /kg/ day Inj. Amikacin 15mg/kg/day Spy . Calpol round a clock. Maintain hydration by IV fluid. If possible invite senior peadrition of your town for visit.
Stappladder Patten of fever Possiblity of typhoid fever Send blood culture(gold standard for typhoid fever) Rule out complicated UTI , incomplete Kawasaki disease, brucellosis, Infectious mononucleosis. Start IV Ceftriaxone after sending blood culture
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