A 9-year-old boy is brought to the outpatient clinic by his parents with a 2- to 3-year history of intermittent fever, abdominal pain, failure to thrive, tiredness, and weakness. The patient has no other symptom in between her illness period. He usually gets tired easily during any sports activity. Work up A complete blood cell (CBC) count reveals a hemoglobin of 10.7 g/dL, a hematocrit of 32% (0.32), and a red blood cell (RBC) count of 3.5 × 1012/L and rest of the CBC are WNL.
The liver function tests, kidney function tests, electrolyte panel, and coagulation profile are all normal. A routine urine examination shows 3-4 white blood cells (WBCs) per high power field, with no trace of RBCs. A urine culture is performed; within 48 hours, over 100,000 colony forming units/mL of Escherichia coli sensitive to ciprofloxacin, gatifloxacin, gentamicin, and amikacin are found. Physical…
