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Re: Dx Challenge at BTGH, questions answered and update From: Dr. Carlos Chase (drchase@caribnet.net) Mon Oct 30 14:50:00 1995 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Mats Bergstrom: "Re: suspected DVT" Previous message: Terrence.Jones@ncal.kaiperm.org: "Central Retinal Vein Occlusion +" Maybe in reply to: Geffrey Klein, MD: "Dx Challenge at BTGH, questions answered and update" >Dr. Chase... > Will standard blood culture reveal Leptospirosis? I will order leptospira > titers. >Updated results... > Preliminary reading of thick smear for malaria negative. No cultures > growing anything yet. Patient spiked twice yesterday to 103 and 104.. > She responded to a cooling blanket. I am hesitant to use acetominophen > in this patient with her picture of liver insult. Any support for this.. > Is there a better antipyretic choice? Other serologies not ready.... Leptospirosis- Blood cultures , urine cultures may reveal organism with dark field microscopy. Note that direct culture is notoriously difficult. Leptospira titres may be more helpful. I also saw dengue fever as a suggestion - tires acute and convalescent can identify individuals exposed, remember though that there are 4 serotypes. I would suggest the old fashioned:- fan therapy, alcohol sponge until liver enzymes are normal. May I ask what her urine output has been like? Dr. Carlos Chase MBBS, DGO Department of Obstetrics and Gynaecology Queen Elizabeth Hospital Bridgetown Barbados E-mail: drchase@caribnet.net Next message: Mats Bergstrom: "Re: suspected DVT" Previous message: Terrence.Jones@ncal.kaiperm.org: "Central Retinal Vein Occlusion +" Maybe in reply to: Geffrey Klein, MD: "Dx Challenge at BTGH, questions answered and update"

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