كليدواژه :
آزمايش , Weight loss , درد مبهم , عفونت
چكيده لاتين :
A 35 year - old man was referred to an infectious disease specialist because of two weeks; fever, fatigue, 4kg weight loss and an obscure pain of whole body. He had otherwise been well until 15 days before. 10 days before; treatment with Procaine Penicillin (800,000 U per 12 hours) and Amoxicillin by a G.P was begun. 5 days later a physician sent him to a lab for routine blood examination and febrile agglutination tests. His physician on physical examination of patient
found a palpable spleen and his temperature was 38ʹc, CRP+ + and ESR was 45 mm per hour. In auscultation, heart and lungs were normal. A urine culture was negative .Blood sugar, Creatinine, Cholesterol and Triglycerides were normal. Hematologic lab values were: Het %40, MCV 82, WBC (Per mm3) 9100, dif count N=35, L=55, E=O, M=8, B=2, PLT=250,000, Blood *chemical *values: Creatinine 0.9, Sugar 95, Calcium normal, Liver enzymes; ALT=50, AST=48. And Tuberculin Test positive with 12 mm indurations.
The patients` weight had dropped from 75 to 71 Kg. The temperature was 38ʹ c .The pulse rate was 75, respiration rate was 22. The blood pressure was 110/70. The urine was positive (++) for protein, Urea Nitrogen 33 mg/dl, Creatinine 1.2mg/dl.
Na 139 mmol; K, 4.5mmol/ lit; Glucose 119 mg/dl; Bilirubin total 1.7 and direct o.6; and normal liver enzymes, EKG showed sinusal tachycardia; the other findings were otherwise normal.Chest-.X-Ray showed no abnormality. Sample of blood was obtained for culture. Temperature was controlled each day and it was maximum 38.3 centigrade. On the next clinical visit of patient ,three days later, serum sample obtained on the seventh day of illness was negative for Salmonellosis and Brucellosis and first report of blood culture was negative too. A CT-Scan of lumbo-saccreal portion and Chest.x.Ray gave no diagnostic information. A diagnostic procedure was performed.
