malaria&dengue in a child-rarest of a rare case .
DR PSELVARAJ.CONSULTANT PEDIATRICIAN,. SRM SPECIALITY HOSPITAL
SRM UNIVERSITY
CHENNAI.
TO
THE EDITOR THE ANTISEPTIC
SIR. I AM SENDING AN ARTICLE FOR YOUR PERUSAL &CONSIDERATION OF
PUBLICATION IN YOUR JOURNAL.
THANKING YOU
DR P SELVARAJ.
MALARIA &DENGUE IN A CHILD.
------------------------------------
INTRODUCTION:WE GET ABOUT 300 CHILDREN PER MONTH WITH HISTORY OF FEVER,RARELY WE GET A POSITIVE SMEAR STUDY FOR MALARIA.THIS CHILD SOUGHT ADMISSION AFTER FAILURE OF ANTIBIOTIC THERAPY,FOR ONE WEEK FOR FEVER FROM A GP.MORE OVER THIS IS SWINE FLU SEASON &PEOPLE ARE SCARED THAT ALL FEVERS COULD BE SWINE FLU FEVER.!
ABSTRACT:A CHILD WAS ADMITTED FOR FEVER OF ONE WEEK DURATION.SHE HAD HEPATOMEGALY LOW PLATELET COUNT LEUCOPENIA,&PLASMODIUM VIVAX MALARIA.SHE MADE AN EVENTFUL RECOVERY WITH ANTIMALARIALS+PLATELET TRANSFUSION.
KEY WORDS:LEUCOPENIA,THROMBOCYTOPENIA,ECHYMOTIC PATCH,DENGUE HAEMORRHAGIC FEVER,IgG IgM ANTIBODIESSWINE FLU.
CASE PRESENTATION:
A 12 YEAR OLD GIRL CHILD WAS ADMITTED FOR FEVER OF ONE WEEK DURATION.SHE LOOKED VERY SICK,AS SHE HAD FREQUENT &SEVERE VOMITING.HER TEMPERATURE WAS 104.F.HAD BLUISH PATCHES ON THE SKIN AROUND ANKLES,REDDISH SPOTS ON THE UPPER ARMS.ECHYMOTIC PATCHES AT 3 SPOTS IN THE UPPER ARMS .HAD
GENERALISED PRURITIS&ALSO LOCALISED IN THE LEGS AT,HEMORRHAGIC
SUB CUTANIOUS SITES.,AS ALSO AT EXTERNAL GENITALIA,MORE NEAR URETHRAL MEATUS.
INVESTIGATIONS:
THE FOLLOWING INVESTIGATIONS WERE DONE:
HB,TBC,DC,ESR,PERIPHERAL SMEAR STUDY ,PLATELET COUNT, BLOOD GROUPING RH TYPING,IgG&IgM ANTIBODIES FOR DENGUE FEVER,URINE C&S FOR 3DAYS.
DIFFERENTIAL DIAGNOSIS:
1)MALARIA:ANY FEVER CAN BE DIAGNOSED AS CLINICAL MALARIA EVEN WITHOUT BLOOD SMEAR STUDY.IN OUR CASE SMEAR WAS POSITIVE FOR VIVAX MALARIA.
2)URINARY TRACT INFECTION:BEING A FEMALE CHILD WITH PRESENTING VOMITING,UTI IS COMMENEST.
3)SWINE FLU FEVER:CHILD DID NOT HAVE ANY RESPIRATORY SIGN OR SYMPTOM
IT COULD BE SWINE FLU UNLESS PROVED BY THROAT SWAB/STOMACH ASPIRATE.
4)CNS INFECTION:THOUGH CONSCIOUSNESS WAS NORMAL,IT COULD HAVE A CNS PATHOLOGY UNLESS RULED OUT BY A CSF EXAM.
5)DENGUE HEMORRHAGIC FEVER:
SHE HAD CLINICAL EVIDENCE OF SUB CUTANEUS HEMORRHAGIC SPOTS,COUPLED WITH LEUCOPENIA &THROMBOCYTOPENIA,GENERALISED &LOCALISED PRURITIS.
LAST BUT NOT LEAST,TOURNIQUET TEST FOR CAPPILLARY FRAGILITY WAS POSITIVE
LAB TEST FOR IgG ANTIBODIES WAS POSITIVE..
THIS IS A COMMON TROPICAL DISEASE LIKE LEPTOSPIROSIS AT CHENNAI.
DIAGNOSIS:
FINAL DIAGNOSIS:
1)PLASMODIUM VIVAX MALARIA
2)DENGUE HEAMORRHAGIC FEVER
3)LUECOPENIA
4)THROMBOCYTOPENIA
5)SUBCUTANEUS HAEMORRHAGE
6)HEPATOMEGALY
SRM UNIVERSITY
CHENNAI.
TO
THE EDITOR THE ANTISEPTIC
SIR. I AM SENDING AN ARTICLE FOR YOUR PERUSAL &CONSIDERATION OF
PUBLICATION IN YOUR JOURNAL.
THANKING YOU
DR P SELVARAJ.
MALARIA &DENGUE IN A CHILD.
------------------------------------
INTRODUCTION:WE GET ABOUT 300 CHILDREN PER MONTH WITH HISTORY OF FEVER,RARELY WE GET A POSITIVE SMEAR STUDY FOR MALARIA.THIS CHILD SOUGHT ADMISSION AFTER FAILURE OF ANTIBIOTIC THERAPY,FOR ONE WEEK FOR FEVER FROM A GP.MORE OVER THIS IS SWINE FLU SEASON &PEOPLE ARE SCARED THAT ALL FEVERS COULD BE SWINE FLU FEVER.!
ABSTRACT:A CHILD WAS ADMITTED FOR FEVER OF ONE WEEK DURATION.SHE HAD HEPATOMEGALY LOW PLATELET COUNT LEUCOPENIA,&PLASMODIUM VIVAX MALARIA.SHE MADE AN EVENTFUL RECOVERY WITH ANTIMALARIALS+PLATELET TRANSFUSION.
KEY WORDS:LEUCOPENIA,THROMBOCYTOPENIA,ECHYMOTIC PATCH,DENGUE HAEMORRHAGIC FEVER,IgG IgM ANTIBODIESSWINE FLU.
CASE PRESENTATION:
A 12 YEAR OLD GIRL CHILD WAS ADMITTED FOR FEVER OF ONE WEEK DURATION.SHE LOOKED VERY SICK,AS SHE HAD FREQUENT &SEVERE VOMITING.HER TEMPERATURE WAS 104.F.HAD BLUISH PATCHES ON THE SKIN AROUND ANKLES,REDDISH SPOTS ON THE UPPER ARMS.ECHYMOTIC PATCHES AT 3 SPOTS IN THE UPPER ARMS .HAD
GENERALISED PRURITIS&ALSO LOCALISED IN THE LEGS AT,HEMORRHAGIC
SUB CUTANIOUS SITES.,AS ALSO AT EXTERNAL GENITALIA,MORE NEAR URETHRAL MEATUS.
INVESTIGATIONS:
THE FOLLOWING INVESTIGATIONS WERE DONE:
HB,TBC,DC,ESR,PERIPHERAL SMEAR STUDY ,PLATELET COUNT, BLOOD GROUPING RH TYPING,IgG&IgM ANTIBODIES FOR DENGUE FEVER,URINE C&S FOR 3DAYS.
DIFFERENTIAL DIAGNOSIS:
1)MALARIA:ANY FEVER CAN BE DIAGNOSED AS CLINICAL MALARIA EVEN WITHOUT BLOOD SMEAR STUDY.IN OUR CASE SMEAR WAS POSITIVE FOR VIVAX MALARIA.
2)URINARY TRACT INFECTION:BEING A FEMALE CHILD WITH PRESENTING VOMITING,UTI IS COMMENEST.
3)SWINE FLU FEVER:CHILD DID NOT HAVE ANY RESPIRATORY SIGN OR SYMPTOM
IT COULD BE SWINE FLU UNLESS PROVED BY THROAT SWAB/STOMACH ASPIRATE.
4)CNS INFECTION:THOUGH CONSCIOUSNESS WAS NORMAL,IT COULD HAVE A CNS PATHOLOGY UNLESS RULED OUT BY A CSF EXAM.
5)DENGUE HEMORRHAGIC FEVER:
SHE HAD CLINICAL EVIDENCE OF SUB CUTANEUS HEMORRHAGIC SPOTS,COUPLED WITH LEUCOPENIA &THROMBOCYTOPENIA,GENERALISED &LOCALISED PRURITIS.
LAST BUT NOT LEAST,TOURNIQUET TEST FOR CAPPILLARY FRAGILITY WAS POSITIVE
LAB TEST FOR IgG ANTIBODIES WAS POSITIVE..
THIS IS A COMMON TROPICAL DISEASE LIKE LEPTOSPIROSIS AT CHENNAI.
DIAGNOSIS:
FINAL DIAGNOSIS:
1)PLASMODIUM VIVAX MALARIA
2)DENGUE HEAMORRHAGIC FEVER
3)LUECOPENIA
4)THROMBOCYTOPENIA
5)SUBCUTANEUS HAEMORRHAGE
6)HEPATOMEGALY
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