A 3-year-old child is presenting with a general failure to thrive in combination with mild splenomegaly...

A 3-year-old child is presenting with a general failure to thrive in combination with mild splenomegaly and hepatomegaly, as well as peripheral lymphadenopathy. The child has a history of recurrent viral respiratory infections and molluscum contagiosum. At the age of 20 months, he had to undergo surgery to remove a tumor from his bowel. Pathology indicated it was most likely the result of a lymphoproliferative disorder. The patient was found to be positive for Epstein Barr Virus (EBV) using blood serology. Serology also indicated the patient was positive for Herpes Simplex Virus (HSV), Varicella Zoster Virus (VZV) and Cytomegalovirus (CMV). Flow cytometry indicated that total lymphocyte count, total B-cell and T-cell count, including T-cell subsets, were within normal limits. Family history indicates that the patient is from a consanguineous lineage and that several cousins also had a history of recurrent viral infections and failure to thrive.

1. What is this patient likely suffering from?

2. How would you confirm your provisional diagnosis?

Expert Solution

1. The child is likely to be suffering from PIDD (primary immunodeficiency diseases) . Which is group of disorders affecting immune system leads to decreased immunity causing various infections in life. These are family inherited type of diseases.

2 . Confirmation of provisional diagnosis is done with the help of presenting symptoms of patient, the treatment history and lab results. In the presenting symptoms we can see typical symptoms of PIDD such as failure to thrive, spleenomegaly, heptomegaly , lymphadenopathy, skin disease like molluscam and recurrent viral respiratory diseases including cytomegalovirus, varicella, Epstein bar virus etc these viruses commonly attack during immunocompromised situations. His family history also suggests his cousins having same diseases . His past health history says he having surgery for mass in abdomen as result of lymphoproliferative disease. Lymphoproliferative disease is a complication of PIDD. However his lab value shows normal T cell and B cell count in flow cytometry but that itself not enough, more lab tests are needed for patient like DNA based testing to find out type of PIDD . So by checking his classical symptoms and history we can provisionally diagnose patient is suffering from PIDD.

Nightingale answered 2 years ago

TB, a 4-year-old male child (38lbs) arrives to the urgent care with a mild fever, nausea,...

TB, a 4-year-old male child (38lbs) arrives to the urgent care with a mild fever, nausea, and vomiting that began the previous day. The patient was prescribed ibuprofen, pharmacy to dose. Please determine the dose, route, and frequency for this patient. Round to the nearest whole number 2. BB, a 6-year-old female child (3’5’’, 46lbs) arrives to the urgent care with a mild fever, nausea, and vomiting that began the previous day. The patient was prescribed acetaminophen 5 grain suppository....

. You are caring for an 11-year-old child who will be receivinga general anesthetic for surgery...

. You are caring for an 11-year-old child who will be receivinga general anesthetic for surgery to repair a fractured femur. Prepare teaching handouts for the parents and the child that address preoperative and postoperative needs.

Jason is a nine-year-old child who developed chronic renal failure after suffering from a streptococcal infection...

Jason is a nine-year-old child who developed chronic renal failure after suffering from a streptococcal infection (strep throat). Jason's renal function has declined steadily over the last three years, and he is currently receiving hemodialysis three times a week. A search is on for a suitable kidney donor. Jason is 4 feet 3 inches tall and weighs 55 pounds. He fol- lows a fluid-, sodium-, potassium-, and phosphorus-restricted diet, His typical energy intake is about 1000 kcalories per day. My...

Sally is a 3-year-old girl presenting to the PCP’s office. Sally’s mother states she is having...

Sally is a 3-year-old girl presenting to the PCP’s office. Sally’s mother states she is having “temper tantrums.” Subjective Data Mother states Sally eats well Sleeps 11-12 hours/day Speaks in four- to five-word sentences Objective Data Birth weight: 3 kg Today’s weight: 13 kg Height: 90 cm Speaks in three- to four-word sentences with a 300-word vocabulary Questions: Is Sally’s vocabulary appropriate for her age? Are Sally’s height and weight appropriate for her age? What information can Sally’s nurse give...

1. At the Integris hospital, a 5-year old Caucasian male child in good general health and physical...

1. At the Integris hospital, a 5-year old Caucasian male child in good general health and physical condition was presented at the Saturday walk-in clinic by his mother. He was brought in because he had a fever, was cranky and had complained of a sore throat for about 24 hours. On physical examination by the attending resident, the patient had a fever of 39.3C, and he had considerable swelling and drainage of the pharynx and in the conjunctivae. His tonsils were...

How does travel affect a 3-year-old child and he is thin with evidences?

3) Jane and Ed Rochester are married with a 2-year-old child, who lives with them and...

3) Jane and Ed Rochester are married with a 2-year-old child, who lives with them and whom they support financially. In 2019, Ed and Jane realized the following items of income and expense: Amount Items: $ 35,000 Ed's Salary, $70,000 Jane's Salary , $400 Municipal bond interest income, $1,000 Qualified business income, $8,000 Alimony paid (divorce in 2018) $10,000 Real property tax (from AGI deduction) Their employers withheld $5,800 in federal income taxes from their paychecks. A) What is their...

Case scenario Ahmed is a 3-year-old child who presented to the emergency department with an acute...

Case scenario Ahmed is a 3-year-old child who presented to the emergency department with an acute asthma episode. He is currently having dyspnea, wheezing, palpitations and bouts of productive cough with whitish sputum. He has a history of four episodes of diarrhea related to eating food from outside. He also has abdominal pain and is clenching his fist, crying and closing his eyes tightly. Ahmed’s mom says he is very adamant and behaves aggressively when he is said no to....

1- several tax payers want to claim eic for the same 3 year old child. they...

1- several tax payers want to claim eic for the same 3 year old child. they all lived in the same household with the child for the entire year and all had earned income. one is the child's father. one is the child's aunt who provided over half of the child's support, and one is the child's grandmother who is the member of the household who had the highest ago. which taxpayers is able to claim EIC?

Jane is a 3-year old female brought into the urgent care clinic by her mother. Child...

Jane is a 3-year old female brought into the urgent care clinic by her mother. Child has been complaining of left ear pain for the past 2 days. She has had fevers with the last at 101 F; mother treated fever with ibuprofen. No cough, vomiting or diarrhea. You are working with a family practice Nurse Practitioner who diagnoses the child with left otitis media (ear infection). The NP selects amoxicillin suspension for treatment. The NP asks that you double...

Question