Approach To A Child With Hepatosplenomegaly-1

Approach To A Child With Hepatosplenomegaly-1 - Approach To...

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Approach To A Child With Hepatosplenomegaly Dr. Pushpa Raj Sharma Professor of Child Health Institute of Medicine
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Case History Eight months, male, from Rupandehi. Fever with cough and difficulty breathing for one week, more severe for one day. Progressive abdominal distension for 4 months. Repeated pneumonia since 3 months of life
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History contd. Uneventful perinatal period. Exclusive breast feeding for 3 months. Repeated treatment with antibiotics since four months of age for cough and fever. Gaining weight. Single child of parent. Other histories including developmental are normal
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Examination Wt: 5 Kgs; Length: 64 cms; OFC: 39.5 cm Apyrexial; R/R: 66/min; P/R: 150/min. No pallor; no lymphadenopathy; no rash; no cataract; no specific body odour. Chest indrawing present; bilateral creps. Normal heart sounds. Liver and spleen 5 and 8 cms below costal margin respectively; non tender; smooth; firm. no ascitis; Other system normal
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Investigations Hb: 12.2.g/dL; TLC/DLC: normal; ESR: 20mm/hr.
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