Female patient of age 35 complain of high grade fever since three days. Chief Complaints Fever Weakness Weight loss History On detail history she tells she had unexplained weight loss since 6months On off fever since 4 months Weakness NO history of DM No history of Htn. No history of cough or cold No chest pain. Vitals Bp:108/70 Pulse: 155 (she told that she always had high pulse rate ranging ( 100-140). Temp:102 Spo2:98 Physical Examination Anemic ++ Palor+ PA:Soft A small swelling along lateral side of neck Investigations Cbc:Hb:10.8 Widal:160+ Urine R/M:NAD Montoux :Negetive ESR:50 I Advice :FNAC( for growth on neck). Blood culture Urine culture Diagnosis DD Granulomatous TB??? FUO?? Enteric fever??? Need opinion Management Need opinion

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Chronic h/o fever and wt loss with raised esr and cervical lymphadenopathy most likely tubercular adenitis Wait for fnac report She also has h/o palpitations or tachycardia Likely sinus arrythmea needs ecg and 2decho So adv xray chest and usg abdomen also Meanwhile treat symptomatically

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Viral Entric UTI Malaria Further evaluation is required for diagnosis and treatment


Thyroid reports normal

Enteric fever.

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