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#ItsTime A 35 yr old admitted with intermittent moderate fever without any chills and rigor and yellowish discoloration of both eyes for last 1month and generalized swelling of abdomen for same duration. Patient had history of intermittent cough with sputum production in the past.No history of respiratory distress, abdominal pain, haemoptysis. Her pulse rate was 102/min, BP-110/70 mm of Hg, with mild pallor. USG of the abdomen showed mild splenomegaly and hepatomegaly with normal echo texture of the liver without any other abnormalities. X-ray was normal. CT of abdomen showed only a mildly enlarged liver without any other mass or lymphadenopathy. What is this case about?

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USG hepato splenomegaly and CT shows mildly enlarged liver but pt seem to be severely jaundiced. One liver function test could have give provisional diagnosis with infective hepatitis where liver enzymes would be found deranged Apart from Infective hepatitis one more condition may be thought haemolytic anaemia considering hepato splenomegaly Other conditions may be clinically evaluated Blood examination LFT Test for Hepatitis A and hepatitis B.

Thanks Dr Gyanendra bath Tripathy
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IT'S A..CASE OF.. ? JAUNDICE .. WITH.. H/O..HEMOPTYSIS.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. * HEMOGRAM.. * URINE ROUTINE.. * LFT..FIBRO TEST.. * HEPATITIS VIRAL STUDY.. * SPUTUM STUDY..CBNAAT.. * USG STUDY ABDOMEN..

Tnx Dr Ashok Leel sir
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Most likely a case of infective hepatitis. D/D- hemolytic jaundice considering hepatosplenomegaly . Needs further evaluation with CBC LFT HBASG , hepatitis C . Reticulocyte count . ESR , PBF

FEVER JAUNDICE HEPATO SPLENOMEGALY CXR = NORMAL POSSIBLITIES = LEPTOSPIROSIS SCRUB TYPHUS TYPHOID FEVER ADV = CBC ESR CRP PROCALCITONIN 2 BACTEC BLOOD CULTURE 3 LEPTOSPIRA IgM AB 4 SCRUB TYPHUS IGM AB 5 LFT P TIME & INR HEPATITIS VIRAL PROFILE AMA ASMA ALKMA ANA 6

HEPATOSPLENOMEGALY HEMOPTYSIS CBC,ESR,LFT,WIDAL, SICKLE CELL,HCV, HBSAG,HIV,IGG/IGM/NS1 DENGUE, ANTIBODY ANTIGEN MP, IGG/IGM SCRUB TYPHOUS, BLOOD AND URINE FOR C/S,TB PROFILE... TO CONCLUDE...

Thanks Dr. Sandeep S
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Seems like a case of hepatitis ? Infective ?? Viral Needs further investigation and evaluation to conclude and line of treatment.

Thanks Dr kute Ankush
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Requires detailed evaluation with complete LFT with PT/INR, serum PROTEIN with A/G ratio, viral serologies like HBsAg, Anti HCV antibody, anti HAV & HEV IgM serology, AUTOIMMUNE work up (if viral workup is negative) .. ANA, ASMA, AMA, anti LKM, etc. Also to get 2D Echo.

History suggest hepatitis Likely hepatitis B Go for viral profile

Thanx dr Sandeep S
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Hepatitis A, B and C pannel. URINALYISIS. PTT, Peripheral blood smear. INR. may be Acute Viral hepatitis. Acute Cholangitis

Hepetomegely.. Spleenomegely.. Needs further evalutions . Liver enzyme tests..

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