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Prepared by...
Virat Sirisanthana, M.D. |
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Department of Pediatrics,
Chiang Mai University
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A 10-year-old hill tribe boy was admitted to CMU Hospital
on Nov 3, 1998
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| Chief complaint: | ||
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High fever for 7 days. | |
| Present illness: | ||
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He has had high intermittent fever without localizing
sign for 7 days. During this period he was given amoxicillin for three
days followed by co-trimoxazole for three days without improvement.
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| Past history: | ||
| unremarkable | ||
| Physical examination : | ||
| a febrile, mild dehydrated boy with normal consciousness | ||
| VS : Temp 39.5oC PR 95/min, BP 110/80 mm.Hg RR 24/min | ||
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HEENT : injected conjunctivae, no
icteric sclera, mild injected pharynx LN : enlargement of bilateral posterior cervical ,axillary, and inguinal nodes Heart : regular rhythm, no murmur Lung : clear, no adventitious sound Abd. : soft, liver 4 cm below RCM with mild tenderness, spleen : can’t be palpable |
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| Ext : no edema, no lesion | ||
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Genitalia : skin lesion at Rt. scrotal sac (Figure)
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Lab : Hb 11.4 mg, Hct 33%, WBC 13,400
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RBC morphology: NCNC, Plt : adequate U/A : yellow, clear, pH 7, sp.gr.1,030, sugar -neg, prot +1 Serum electrolytes: Na 131, K 4.7, Cl 97, CO2 25, BS = 108 mg% |
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| Question: 1. What is the diagnosis? | |