A 5-year-old boy has intermittent fever, muscle pain, cough, and blocked nose for the past four days. The temperature is shooting up during nights and is normal during the day time.
The blood test results are:
CPK 23056 U/L.
SGOT 513 U/L.
Leptospira IgM and dengue IgM tests in progress.
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The reports and history are suggestive of some viral etiology probably, however, it is advisable to do a blood culture also to rule out bacterial etiology. In the meantime, I would advise starting Ceftriaxone to be on the safer side along with proper iv (intravenous) fluid management. Other symptomatic management like nebulization and antipyretic medications to be given as per the symptoms.
To trace blood culture, dengue and leptospira results and act accordingly. If symptoms worsen or do not resolve in the next five to seven days, detailed investigations in favor of Duchenne muscular dystrophy should be carried out.
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