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Jaundice, breathing trouble, nasal polyps, hepatomegaly. Blood reports showed leukocytosis, elevated platelets and WBC. Diagnosis?

Hi! am Getruda George, There is a kid of 3yrs came with jaundice , fever and diff. on breathing for 3days on examination, there is nasal polyps, hepatomegally about 5cm below right coastal margin. LFT results aspartate aminintransferase, total bilirubin are high, full blood picture shows leukocytosis, rised platelets and WBCs. malaria and hepatitis b tested negative. what could be the problem
Asked On : Mon, 30 Jul 2012
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General & Family Physician 's  Response
Obviously you should consider Hepatitis A, as well as Epstein Barr Virus and Cytomegalovirus which can both give an upper respiratory tract picture with enlarged lymph nodes, liver or spleen. Cholangitis (Virchov's triad of fever pain and jaundice) is also in the differential diagnosis as is a pyogenic live abscess although that is pretty rare. I would certainly focus on supportive care (hydration, oxygen, possibly empirical antibiotics) while organizing an ultrasound of the liver and biliary system. This child sounds sick and should be cared for in a hospital if possible.
Answered: Tue, 3 Jun 2014
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