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[|Human|] 24 yrs primi with 5 month pregnancy presented with lower abdominal pain and high grade fever with chills 15 days. Initially treated on line of UTI as urine R/M shows pus cells and culture revealed yeas cells. But fever of high grade persisting with abdominal distension . USG abd. revealed mild to mod ascites with omental thickening and ascitic fluid shows exudative fluids with raised ADA & LDH. Mx negative but TB Gold +ve. Her initial TLC 10,640 and Normal KFT.
[|AI|]  Welcome to Chat Doctor .... Ascities with an oxidative picture on ascetic fluid analysis - suggests infection. Now what infection is the issue ?? 1) Bacterial - yes possible, Fever with chills, oxidative picture on ascetic fluid analysis is supportive. But counts TLC is not very high that's against. I would have liked to know what is the Ascetic fluid cell count and the cell type-if predominant neutrophils (PMN s) and count > 250 is strongly suggestive of bacterial infection - treatment would be with a third gen cephalosporin like ceftriaxone and metronidazole. 2) Second possibility is TB Abdomen, Raised ADA, Tb Gold positive are supportive and manitou negative is against Tb. I would like to know if ascetic fluid was examined for gram stain and AFB, if AFB is positive then it's a definite Tb and requires anti tubercular treatment with 3 Chat Doctor. I would like to know 2 things 1) What is the Cell count and cell type report of ascetic fluid analysis?2) What is gram stain and ZN stain for AFB report of ascetic fluid analysis ? These can help me. Help you with the diagnosis.