A 2 1/2 yr old male baby was brought with complaints of puffiness of face, vomiting, passing dark colored urine since one day. H/o fever 4 days back for 2-3 days for which aceclo para and some medicine was given on the advise of a neighbour. Patient got urine exam and cbc reports. O/E there was irritability, pallor, puffy face, b.p .100/60 ,Hr 100, no resp distress, lungs clear. P/A epigastric tenderness 3 finger liver. Urine R/E showed 3plus RBC. CBC Hb 9.5 TLC 7400 P57L35E7M1B0 HCT 30.2 Platelet 1.75 ,PDW14.1 MCV 67.3.
I advised Dengue, Ns1, IgG, IgM and USG whole abd and urine C/st, Cholestral S, creatinine, bd urea, LFT. Dengue serology was IgM positive, NS1 IgG negative. USG showed diffuse gallbladder wall oedema with mild ascitis and minimal rt. pleural effusion. Please comment on the diagnosis and management.
