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Recurring abdominal pain, loose stools post treatment, tests showed high SGPT, awaiting results for widal, blood culture, urine. Differentials?

I have a patient who had abdominal pain and loose stools for 3 weeks.travelled from pakistan 10 year old.stool routine analysis ,urine analysis and ultrasound were normal.treated with metronidazolefor 7 days and he improved but after 5 days now he came now with 4 days of fever ,cough,loose motions,vomitting and abdominal his blood analysis done.CBC, CRP ,-normal.BUN-5,creat-normal,but SGPT-1820 raised.widal,blood cultureand urine analysis awaited.what should be the differentials
Asked On : Wed, 3 Oct 2012
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Pulmonologist 's  Response
Thanks for your query.
Your patient has a highly elevated serum SGPT level. In this case you should go for total liver function test (LFT) which include total bilirubin, conjugated and unconjugated fraction, serum albumin, SGOT, SGPT and alkaline phosphatase level. Along with these you should also have hepatitisB surface antigen (HBSAg), anti-HBSAg, test for hepatitis c virus (ANTI-HCV), hepatitis A virus (Anti-HAV), Hepatitis E virus (Anti-HEV). Also wait for the other results to come which you have sent. It may be a case of viral hepatitis. If alkaline phosphatase and conjugated bilirubin is very high you should have an ultrasonography (USG) of abdomen. Keep the boy on bland diet, plenty of water per mouth and liver tonic and digestive enzymes until further diagnosis is reached.
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Answered: Wed, 3 Oct 2012
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