A 4-year-old girl presented with fever since 8 days, there was no other localising symptoms besides fever, on examination child is conscious, oriented, throat was normal, the child was sick looking, febrile, there was of hepatomegaly of about 4 cm, just palpable spleen.all other systems were normal.investigation shows CBC hb6 tlc23000 plt467000, urine normal, widal negative, malaria antigen, dengue was negative. Blood culture sends shown no growth after 48 hours. A chest x-ray is normal. The child was started on inj ceftriaxone enteric dose,5 days back, her toxicity reduced, oral intake increased but she still has fever spikes of 101- 102F daily once or twice.we also send typhoid, which came negative.
We don't have the definite diagnosis even after 7 days of admission. All routine investigations are inclusive except high total count with neutrophilc predominance. What can be other…
