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What Is The Possible Diagnosis And Management For The Following Report?
male patient 35 years. has intermittent fever with rigors and loss of appetite since 2 weeks. every day at 6.00 p.m his temp. rise to 39.5 with rigors. he has leukocytosis (23.000). malaria blood film is negative, abd.ultrasound is normal , urine test is normal , widat test is 1/160. he take rociphen for 3 days now but with no response. what is the possible diagnosis and management ?
Mon, 14 Apr 2014
Hello
Fever with rigors , low grade fever, leucocytosis ( mild degree ) with loss of appetite .
Evening rise of temperature are suggestive of following .
1 Typhoid fever as in one strain 1:160 is an indication of typhoid . Diagnosis can be confirmed by serology test .
2 Jaundice or hepatitis is another reason which develops such type of symptoms . Diagnosis can be confirmed by blood examination for H B ASG for A , B ,C E .
3 Tuberculosis , as all indication are suggestive of tuberculosis . Diagnosis can be confirmed by Xray chest and C B C & E SR.
As you mentioned that leucocytosis is there ( although mild degree ) but it is an indication that patient may have infection .
Regular blood examination is very important in this case for T L C ( if elevation , danger ).
As you mentioned that patient is taking rociphen that only act up to certain limit . Meningitis is another reason of such fever.
In my opinion deal according to above mentioned reasons.
Fever with rigors , low grade fever, leucocytosis ( mild degree ) with loss of appetite .
Evening rise of temperature are suggestive of following .
1 Typhoid fever as in one strain 1:160 is an indication of typhoid . Diagnosis can be confirmed by serology test .
2 Jaundice or hepatitis is another reason which develops such type of symptoms . Diagnosis can be confirmed by blood examination for H B ASG for A , B ,C E .
3 Tuberculosis , as all indication are suggestive of tuberculosis . Diagnosis can be confirmed by Xray chest and C B C & E SR.
As you mentioned that leucocytosis is there ( although mild degree ) but it is an indication that patient may have infection .
Regular blood examination is very important in this case for T L C ( if elevation , danger ).
As you mentioned that patient is taking rociphen that only act up to certain limit . Meningitis is another reason of such fever.
In my opinion deal according to above mentioned reasons.
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