The man has lost about 10 kg in last 3 yrs. He is having pain in the abdomen. Semiformed to hard stools on off. Excess borborygmi, anorexia, bleeding piles, increasing pallor, extreme weakness for several yrs and lack of drive to work. He didn't get benefit of treatment by several physicians. On very discounted cost following invest I got done CBC: hb 4.4.rbc 1.8.platelet 1.5.mcv 83.mch.24.mchc29.p50.l42.e8. PS: 45 % RBCs are macrocytic. TSH 21.9 Prot 5.alb 2.9.glob 2.qsgot 10.pt 15.bil .9 Ca 8.4 Triglyceride 107.chol 103 Cr 0.9 na 153.k 37. S. typhi O and paratyphi AH 1/320 UR pus + E.coli 100000.
Stool ascariasis. So the diagnosis was done as mentioned below: Typhoid and paratyphoid. UTI Ascariasis. Hypothyroid. Hypoalbuminemia and calcemia. Dimorphic anaemia. But the ultimate diagnosis was cracked after 2 more investigations. What could be the final investigation and the diagnosis?
