ashokmv Posted October 1, 2013 Share Posted October 1, 2013 We have a 1 month male baby, who has been referred for hepato-splenomegale, and peritoneal lymphadenopathy , confirmed by ultrasound abdomen , no other significant history , no fever no other signs of sepsis. Anti-natal history of mother getting on and off fever from gestation of 5 months, Mother u/s ab : omental thickening, ? TB Baby on DBF We suspected sepsis, lymphomas , infiltrative disorder , congenital tuberculosis . Sepsis screening - negative , baby is not sick TB; gastric aspirate, PCR for TB is negative LFT-normal, PT ptt : Normal Immunoglobulin levels -normal VDRL, HIV, NEgative Hb: 9.5, TC : 9000, platelets : 1.2L Bone marrow - ? Normal study Please give your opinion , what to do further , THANKYOU Link to comment Share on other sites More sharing options...
tpillay Posted October 2, 2013 Share Posted October 2, 2013 suspected congenital tuberculosis is a tough one; is the mother on TB treatment? a) What did the baby's CXR reveal (although congenital TB can present with no CXR findings initially, it will still be worth checking) mantoux interpretation and TB interferon gamma assay (TB Elispot) aalso difficult to interpret in endemic environment and considering age; nevertheless a positive result would indicate infection at least and with symptomatology you would be obliged to treat as Tb disease In my experience, with suspected maternal TB in an endemic setting for TB, and a baby symptomatic for a chronic infection, we have offered a course of TB treatment. Will also be worth checking CMV status Link to comment Share on other sites More sharing options...
ashokmv Posted October 5, 2013 Author Share Posted October 5, 2013 Mother TB screening is negative, Mother not on TB Rx , TORCH PROFILE IS NEGATIVE Baby chest x ray normal Now we r working towards infiltrative disorders Sent for kariotyping , Link to comment Share on other sites More sharing options...
ashokmv Posted October 21, 2013 Author Share Posted October 21, 2013 Transient myeloproliferative disorder (TMT ) suspected by hematologist, but cytogenetic is normal study How to move forward ? Link to comment Share on other sites More sharing options...
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