Her White cell count is mildly elevated, her serum ALT and AST concentrations are twice normal and her ALP is slightly elevated.
Which one of the following investigations is most likely to help guide your management?
A. FNA of a LN
B. HBsAg
C. CMV IgM
D. Heterophilic antibodies
E. HIV test
Answer:
D. Heterophilic antibodies
Discussion: The Hx is strongly suggestive of infectious mononucleosis, which can be confirmed by a
heterophilic antibody test (Monospot). Around 80% of pts at this stage of the illness will have a
positive test. However, if the Monospot test is negative, it should be repeated a few days later.
Specific serological tests to detect the presence of Epstein–Barr virus should be requested if it
is still negative and there is a high clinical suspicion of glandular fever. If the EBV tests are
negative then other causes for heterophilic negative acute mononucleosis – including HIV, CMV
and toxoplasmosis – should be considered. The LFTs are not sufficiently elevated in this Pt for
acute viral hepatitis. Other features of a systemic viral infection are present and therefore there
is no indication for requesting Lymph node aspiration. Clearly, management of this Pt depends on a correct diagnosis. The most frequent misdiagnosis is of bacterial tonsillitis and antibiotic Rx given to someone with glandular fever might result in a severe drug reaction. Confirmation of glandular fever would suggest the need for corticosteroid management of this Pt who is toxic and has profound
thrombocytopenia. It would be unusual for the acute HIV retroviral syndrome to present with
marked exudative tonsillitis and splenomegaly, although a reported sexual Hx negative for risk factors does not exclude HIV infection.
Don't You Think It's High Time You Tried Herbal Remedy?
ReplyDeleteIn 2015, I was diagnosed of genital herpes.. I was 21 years old and I had no idea what that was. When my doctor explained to me what Genital Herpes was all about and what type I had...I was freaked out! if I had missed coming to the ER any sooner, I would have possibly died without having the slightest clue of what led to my death, as i have never heard of, or experienced the virus before! The rashes grew and i have been living with it ever since then. Most of the time, I feel dirty knowing i was living with herpes. Though the doctor already encouraged me to keep using my medications even though there is no permanent cure for the virus. So i continued with my medications, which only makes the rashes to disappear, and reappear after some days. Late last year, I started surfing the web, seeking for herbal treatment as alternative. So i was on YouTube one evening,i stumbled upon a comment about Dr. Ugo and how his herbal medications cured a woman's daughter of Herpes and I decided to reach out to him. He asked me some questions which i answered, after which He prepared some herbs and sent them to me. He then guided me on how to use them. i used the herbal medications for about ,21days. The rashes gradually dried up. So i went for a test and came back home Herpes free. So My experience with this virus made me to realize, people should find out more about themselves before it's too late. So that when tested positive, they will quickly start making use of the right medication because i believe when the right medication is applied, then the sickness is conquered! If you are having any sickness or virus and needs deliverance contact Dr.Ugo (for your permanent healing) He is the right person to tell your health challenges to. You can contact the doctor via his email address : ugoherbalhome@gmail.com
ReplyDeleteI feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
I was so happy that day, i wanted to be there but the distance was a barrier to me. I told him how the virus had eaten me up and and a truly believe there's cure for herpes. He told me me with assurance that my case wont be different and he had been curing lots of people With his herbal medicine and most people due contact him from the States and preperd the medicine and made use of the DHL to reach him.
Honestly speaking Dr. Akpu power his a great and gifted herbalist,His destined to herbs.
He made me do away with the medical prescription,the acyclovir (Zovirax), famciclovir(Famvir), and valacyclovir (valtrex). you don't know him because you haven't meet this man try and contact him yourself Dr. Akpu in Africa is popularly known in his City,and you can request for his address yourself. I'm so happy now cos,I and my cousin had been confirmed negative till date..the Lord is good in my life. Dr. Akpu sent me his herbal medicine that heal me too, 🙏 🙏 Dr. Akpu for giving me another life.
Contact Dr.akpu for all kids of sickness@
Dr.akpupowerherbscenter@gmail.com
Thank you so much all the way for taking your time to share this unique articles, testimonies and videos about herpes cure.
ReplyDeleteIt's my first time to share my feelings publicly, but I made a vow to accomplish it this way so through me others can be safe to reach out Dr. Odey Abang for any cure to their viruses/ Diseases
I'm David Mark. I had this feelings that they could be a cure to all this deathly and common Diseases. My case was admitted after a ran for my reqular monthly checkup and was shocked when I was tested Herpes Simplex Virus.
I thought this could be a way the wants be to keep patronizing them, Encouraging me to be taking in the antibiotics, the Acyclovir medicine, but wasn't comfortable living on drugs, the case was getting out of hand, affecting my job and life , sore keeps reappearing lots of nightmare thinking about my cure.
Had to engage myself seacking for means online since I'm and information technologist.
I made lots of reaserches seeing Dr. Odey Abang, curing people
Yes, I never met him before,but when I did contact him from the email given, he fulfilled his promise as said and sent me the Herpes medicine together with the powder and instructions on how to apply, two weeks later it finished and was allowed to go for test, then I was confirmed negative.
Have been to different hospitals and the results still shows negative, in me I knew it works and the confidence in me made my friends who where both Herpes carrier where very curious and they all got their cures.
Don't think your not saved with what you have, God has saved us, Dr. Odey Abang can cure you from HIV/Aids/Cancer/Diabetes/Sickle cell/And most dangerous sickness.
Contact him
odeyabangherbalhome@gmail.com
Or Whatsapp
+2349015049094
I'M Kelly FROM KENTUCKY.
ReplyDeleteI wanna thank God for Using Dr. Odey Abang to restore my son's Happiness. He came from school crying that he was diagnosed of Herpes and his teacher and the Physician Therapist told him he could not get a cure rather living on drugs, he never talk to us about it anymore not knowing he plans committing suicide . I had to monitor him and explain to him that he should manage the prescribes ACYCLOVIR, , FAMCICLOVIR and the VALACYCLOVIR.
4 months later, he told me about an Herbalist who he heard curing people from online and he sents through the DHL service. Not quite long,he brought his phone, had to speak with the Herbalist and explain how my son had really felt and desperate in need of the cures, he assured me with no site effects after taking the medicine and promise to do as he said, 5 days later, t medicine arrived, applied as instructed and within two weeks to finish,I had my son told me he was wondering why all this while,they have not approved the cures of which doctor ODEY told him he Cures.
Rest assured, after the checkup, he tested negative and his smiles was being restored.
supriesed Herpes could be Cured!!!☔💯
If you're in trouble of health
HIV/AIDS, DIABETES, Herpetites, KIDNEY PROBLEM, INFERTILITY, INFECTIONS, IRREGULAR MESTURATION, WEEK ERECTION, CANCER ETC
ALL THIS ARE CURABLE WITH HERBAL REMEDIES BY FROM DR. ODEY ABANG
Kindly contact him for more information on health and Safety solutions @
odeyabangherbalhome@gmail.com