My neighbour brought his 2 year old (my previouse Proff told me DO NOT SAY OLD in adults can be rejected, but this is a boy!!!! ) child tonight with on/off fever for the last 3 months, been treated with 3 courses of antibiotics 5 days each, erythromycin, augmentin and ?
Still having fever runny nose (yellowish thick discharge), but child is active, feedind little decreased, no vomiting, no diarrhea.
He has generaliized lymph adenopathy -(non tender, firm, mobile, not matted, 1 cm, non fluctuance, not reduced in size for 14days)with a just palpable liver,
?
dd?
1. proliferative
EBV
Toxo, rubella,
CMV
Strep? staph?
Cat scratch? so many cats in Kubang kerian (Bandar Bharu)
TB
2.infiltrative
3.
VIT
A dermatomyositis, SLE,
M Gaucher disease, Niemann pick disease
INE-
C Castleman disease http://www.castlemans.org/
Ix - not for biopsy yet - not yet 4-6 weeks, not increasing markedy, not fixed, no weight loss, no night sweats
He asked me what to do? even i do not know whrer to go, see in KRK? then they will refer to paeds general clinic on Sunday afternoon, then the MO cliniic may not be happy, can they come to ward? no, then???
lets see wat happens
ref; Nelson pediatrics
No comments:
Post a Comment