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
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 (Virchow triad of fever pain and jaundice) is also in the differential diagnosis as is a myogenic live abscess, although that is pretty rare. I would certainly focus on supportive care (HY Chat Doctor.  This child sounds sick and should be cared for in a hospital if possible.