Fever without localizing sign in a 10-year-old boy (Page 2/2)
Prepared by...
Virat Sirisanthana, M.D.
Department of Pediatrics, Chiang Mai University
Answer: Scrub typhus
In October 1998 : A 3-year-old boy came in with intermittent fever for 10 days. He had generalized lymphadenopathy and hepatosplenomegaly (liver 4 cm. below RCM, spleen 2 cm. below LCM). The left post aricular lymphnodes and poaterior cevical lymph nodes  enlarged significantly with 5 mim. skin lesion as in figure (?eschar).
3yo-arrow.jpg (50256 bytes)
atypical-eschar.jpg (46832 bytes)
The second case : Nov 98 :
A 4-year-old girl with fever for
8 days had generalized lymphadenopathy, hepatomegaly and "eschar"
eschar-1.jpg (37740 bytes)
closed-up eachar.jpg (46303 bytes)
The third case : Jan 99 :
A 8-year-old hill tribe girl with fever for 7 days had generalized lymphadenopathy, hepatomegaly and "eschar"
eschar-1-location.jpg (34573 bytes)
eschar-3-closed-up.jpg (30861 bytes)
 
  Question: What is the treatment of choice ?
What are the other manifestations in the second week of  fever?
   
  What is the "ESCHAR"? Does every patient have "eschar"?
 
  The Answers are in topic "Rickettsial Disease in Human" (in Thai) in page"
Topic for Medical Students and House Staff  (Intranet Use ONLY) "
 
 
 
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