PICU 1 25092017 9yr female 22kg GTCS episode f/b prolong loss of conciousness f/b alterd sensorium(at 22 september 2017)sunken eyes with hepatomegalae Neck rigidity abscent Pupils normaly reactive non photophobic Cracked pot sign negative At present sensorium allert H/o intermittent fever without chills NCCT wnl reports attached Our ddx dengue fever with viral encephalitis vs hepatic encephalopathy 1.Kindly Add ddx 2.what is the cutoff size of the sludge ball within gb as shown in USG 3.what are causetive aorganism possible and what should be DOC and preventive measures according to you Thank you


clinically history and Labs suggests more of Dengue fever with hepatomegaly and Viral encephalitis...Less likely Hepatic encephalopathy as LFT are not that much deranged... Report wise 9.2 mm GB sludge not making any sense...They should label it as GB stone or sludge ( sludge size difficult to meausre).Any way there is no need of treatment for the same..

What is cutoff size of sludge for surgical intervention?

Is lft abnormal or serum ammonia elevated What is the basis of hepatic encephalopathy diagnosis? If a patient is alert theres no encephalopathy Single seizure and a normal contrast ct could be due to any cause Does any test reveal malaria? There is no evidence of encephalitis or encephalopathy Just single seizure episode and intermittent fever.please revise dds.

Cerebral malaria and enteric encephalopathy are other dds because these two diseases are more prevalent in our country

Thank you sir

Enteric encephalopathy Cerebral Malaria Dengue Fever Scrub Typhus.... ......Did u send Blood culture??

Cerebral malaria.

Dengue hepatitis With seizures?aseptic meningitis

Cerebral malaria can be a dd

Thank you sir

Enteric encephalopathy

Mostly I go in favour of enteric enceph Next dd cerebral malaria

Cerebral malaria ruled out

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