Table of Contents

HK J Paediatr (New Series)
Vol 12. No. 2, 2007

HK J Paediatr (New Series) 2007;12;144-145

Clinical Quiz

What is the Diagnosis?

WKY Chan, BCP Wong, TW Fan, PS Yeung


Case History

An 18-month-old boy, with good past health, was admitted for persistent fever for 1 week. There was no obvious localizing symptom except passing loose stool for 2 times on the day of admission. On physical examination, vital signs were stable and abdominal examination showed a ballotable right kidney. Investigations showed white cell count 22 x 109/L, haemoglobin 10.2 g/dL, platelet count 583 x 109/L. Serum sodium was 135 mmol/L, potassium 4.6 mmol/L, urea 6.2 mmol/L and serum creatinine was 51 umol/L. Urine microscopy showed WBC >100/c.mm and RBC was negative. His nasopharygeal aspirate for Influenza A was positive. An ultrasound abdomen was performed.

Question

  1. Figure 1 showed the ultrasound of his right kidney and what did it show?
  2. What further investigations would you perform?
  3. What were shown in figure 2 and what was the diagnosis?
  4. How would you manage the patient accordingly?

Figure 1

 

(a) (b) (c)
 
(d)
Figure 2

N.B. The Editors invite contributions of illustrative clinical cases or materials to this section of the journal.

 
 

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