Investigatons

Case Report 1

Case Report 2

Case Report 3

FBC PCV

29%

30%

30% (At admission)

19% (one week after)

27% (post transfusion)

WBC

DIFFERENTIALS

7 × 109/L

Neut. 57%

Lymph. 29%

Mono. 7%

Eosino. 7%

3.7 × 109/L

Neut. 45%

Lymph. 42%

Mono. 7%

Eosino. 5%

Baso. 1%

2.95 × 109/L

Neut. 44%

Lymph. 30%

Mono. 21%

Eosino. 5%

225 × 109/L

PLATELETS

BLOOD FILM

336 × 109

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216 × 109

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RBC: Severe hypochromia with microcytic and macrocytic cells, few normocytes seen

WBC: white cells appear reduced in film. Neut show left shift to band forms.

PLATELETS: Anisocytosis

IMPRESSION: Sepsis?

r/o bacterial, viral

Severe anaemia likely nutritional (fe or vit b₁₂)

Blood negative

Urobilinogen positive

Bilirubin: positive

Protein: negative

Nitrite: positive

Ketones negative:

Ascorbic acid: negative

Glucose :negative

PH: 6

URINALYSIS

Blood negative

Urobilinogen negative:

Bilirubin: positive

Protein: negative

Nitrite: negative

Ketones negative:

Ascorbic acid: negative

Glucose: negative

PH: 6

Blood negative

Urobilinogen negative:

Bilirubin: positive

Protein: negative

Nitrite: negative

Ketones negative:

Ascorbic acid: negative

Glucose: negative

PH: 7

1st 2nd

Na: 132 132

K: 4.2 4.6

Bicarb: 23 18

Urea: 3.6 3.5

Cr: 60 50

E/U/Cr(mmol/l)

1st 2nd

Na: 140 140

K: 4.2 2.7

Urea: 2.5 1.5

Bicarb: 23

Na: 136

K: 3.7

Bicarb: 27

Urea: 2.1

Cr: 85

T.B: 7 umol/l

C.B: --

AST: 81 U/L

ALT: 48 U/L

ALP: 170 U/L

γGT: 214 U/L

Total Protein: 83 g/l

Albumin: 27 g/l

Abdominal scan

USS: enlarged liver 16.31 cm in craniocaudallenght. No intra/extra hepatic biliary/vascular channels dilatation. No mass seen.

Trophozoites of P. Falciparum

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Trophozoites of P. Falciparum

RVS: seronegative

HbsAg: negative

HCV: negative

Blood film for M.P

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Trophoites of P. Falciparum seen +