Mar 11, 2008

typhoid or malaria?

This is my colleague's case report
but i think I am in different view towards report

22 Feb 2008
Name : Mr. X
Age: 32
S : Fever since 2 days ago until now, Malaise,headache ,abdominal pain , constipation , Dysfagia (-) ,Last Travelling (-) just staying in SA for one a half year

O : BP: 120/70mmHg, HR: 96x/M, T: 38,6 C ,Conjunctival pallor (-/-) ,Tonsils n Pharynx: red swelling T2/T2 ,Chest : Normal Rhonchi and wheezing (-/-) ,Abdominal: Normal ,Extremities are normal

A: Acute Tonsilopharyngitis n malaria Suspected

P: Oral antibiotic ( cefaclor for tonsilopharyngitis)
n come back when the antibiotics finished, and syndrome not diminished

3-4 days later

S: Headache and fever not diminished ,malaise become worse ,constipation (-) and Diarrhoe (+) with bleeding (+)

O: BP: 120/70mmHg, HR: 96x/M, T: 38,6 C ,Conjunctival pallor (-/-) ,Tonsils n Pharynx: normal ,Chest : Normal Rhonchi and wheezing (-/-) ,Abdominal: Normal ,Extremities are normal

A: Malaria suspected

P: thick and thin blood films and came back for the result in 2 days

2 days later
S n O still the same and thick and thin blood films are negative
My colleague gave him antibiotics, makrolide, roxithromycin (rulide)
What do you think?
i suspected his patient of having 'typhoid fever'

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