A young child with fever and unexplained acute kidney injury: Questions

Excerpt

A 3-year and 10-month-old boy presented to the outpatient department with history of fever on and off since 7 days with vomiting, loss of appetite, and decrease in urine output since 3 days. Investigations done outside showed renal dysfunction—serum creatinine—9 mg/dl. On examination, he was found to have high blood pressure and splenomegaly. He was admitted in pediatric intensive care unit and underwent urgent hemodialysis in view of advanced renal failure and hyperkalemia. He was also initiated on broad-spectrum antibiotics. Investigations revealed anemia and thrombocytopenia and transaminitis (Table 1). Investigations were ordered to detect cause of fever; blood and urine cultures did not show any growth. Test for malaria antigen, dengue serology, Widal test, Weil Felix, and Leptospira serology were also negative. …