A Patient with c/o low-grade fever since 3 months, associated with chills and rigors, continuous in nature, headache, body pains, dry tongue, difficulty in swallowing. Parotid gland swelling, sub mandibular glands swelling, no burning micturition, no cough, no diarrhoea, no vomiting, no other swelling over the body, h/o jaundice since 2009, no significant family history of and well immunized. On examination patient c/c/o fever-101 °F, pulse 90 bpm, BP-90/60 mm Hg, CVS-normal heart sounds, resp-bae+no abnormal sounds, p/a soft, scaphoid, splenomegaly 12.5 cm, blue discolouration of nail beds, strawberry tongue. Palate inflammation and pharynx inflamed, Hb-11, WBC-1700, PLT-63000.
Normochromic, normocytic. Renal profile normal/liver function test AST 250, ALT 210 others normal. Brusolosis IgM negative, dengue negative, malaria negative and Widal also negative. What would be the most…
