Dr. Rishabh Dixit (Internal Medicine) needs a second opinion on this medical case.
A 45 year old male, a non alcoholic with no major illness in past, presented with fever since 5 months( on and off, high grade, no joint pain) . Gen weakness since 5 month. Patient had a history of cavity in tooth and abscess there which was extracted locally near his residence.he was also prescribed antibiotics for the same. Now patient reffered to us with severe anaemia and blackish brown spotts over fingertips of all 4 extremeties. Pallor +++ Platelets low 58000 as mentioned. Spleen 2 cm below costal margins. Cva normal, no signs of SABE Bilirubin normal. He was earlier treated for enteric fever and megaloblastic anemia in some hospital where blood culture was normal and all other reports attached( white ones) Gbp is awaited. Marrow is planned once platelets are normal. Givin 2 units of prbc. What will be the dd and further management plan. Hb fall from 7 to 3 in three days duration. With no signs of hemolysis.
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