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Suffering From Fever And TLC Level Is 0. What To Do?

Posted on Sun, 29 Sep 2013

Question: hi sir my father is suffering from fever from last 35 days and his tlc counting is 0000 please help me out what i have to do

Answered by Dr. Rhea Chanda (55 minutes later)

Brief Answer:
Many possible causes for fever

Detailed Answer:
Hello XXXXXXX

Thanks for your query.

Fever is a symptom of many conditions. Fever usually means that there is infection in the body. The foci of infection needs to be determined with the help of tests.

Several blood tests need to be done.Total count of 30,000 is very high. Having fever for over a month is very significant. Further blood tests for malaria,dengue, tuberculosis, typhoid, parasitic infection need to be done. Even is blood culture may be required. He needs to be examined properly and a detailed history will help narrow down the possibilities.

He also needs hospitalization and antibiotics.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rhea Chanda (1 hour later)

thanks for your valuable suggestion i am sending you some reports please go through with the reports and give me your better advice and what i have to do is it need to be hospitalization
please reply me with your suggestion

Answered by Dr. Rhea Chanda (15 minutes later)

Brief Answer:
Malignancy is a possibility

Detailed Answer:
Hi,

Thanks for writing back.

According to the reports,the pelvic mass being solid isnt a good sign. The possibility of malignancy is present. I would advise a biopsy of the mass be done. Ultimately the histopathology is confirmatory. The routine blood test is ok except for the high TLC count. The PSA antigen also seems to be normal. So prostatic cancer may not be the case. But malignancy if the lymphatics could be a possibility. I would suggest you get the biopsy done. The fever is obviously due to the mass. His immunity may be low, hence broad spectrum antibiotics coverage may be needed.

regards,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rhea Chanda (7 hours later)

as per your answer i just want to tell you that fever is on 98 degree before 3 days and TLC is continuously increasing i just want to tell the compression of hematology
from 07 sep reports against 10 sep
BEFORE AFTER (10.09.13)
TLC- 0000 0000
HAEMOGLOBIN 10.8 11.5
POLYMORPHS 87 90
LYMPHOCYTES 10 8
MONOCYTES 02 01
EOSINOPHILS 00 00
PLATELETS 3.12 LAKHS 4.79
RBC 4.46 4.66
PCV 34.6 36.2
MCV 77.6 77.7
MCH 24.2 24.7
MCHC 31.2 31.8
RDW 14.8 14.9
PLEASE SEE THE COMPRESSION OF THE REPORTS AND TELL ME THE HOW TO CONTROL THE TLC COUNTING AND SUGGEST ME THE APPROPRIATE MEDICINE

Answered by Dr. Rhea Chanda (10 minutes later)

Brief Answer:
find the cause

Detailed Answer:
the total count is steadily increasing. That means the body if fighting a foreign body or infection. The count increasing steadily needs to be monitored after hospitalisation and daily blood counts. The treatment will depend on the biopsy repory. If malignancy is confirmed then surgery and chemotherapy will be advised. Lymphoma or leukemia needs to be ruled out. The mass is solid and very large. It will cause compression against major structures if not removed. He needs to see a surgeon for the fnac asap.

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Above answer was peer-reviewed by : Dr. Shanthi.E