A young man repos with history of 6 kg weight loss in 3 month and on examination found to have generalized lymph node enlargement. Likely possibilities are following EXCEPT –
Correct Answer: Chronic malaria
Description: Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma, or death.Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later.In those who have recently survived an infection, reinfection usually causes milder symptoms.This paial resistance disappears over months to years if the person has no continuing exposure to malaria. The signs and symptoms of malaria typically begin 8-25 days following infection,] but may occur later in those who have taken antimalarial medications as prevention Initial manifestations of the disease--common to all malaria species--are similar to flu-like symptoms, and can resemble other conditions such as sepsis, gastroenteritis, and viral diseases.The presentation may include headache, fever, shivering, joint pain, vomiting, hemolytic anemia, jaundice, hemoglobin in the urine, retinal damage, and convulsions. The classic symptom of malaria is paroxysm--a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days (teian fever) in P. vivax and P. ovale infections, and every three days (quaan fever) for P. malariae. P. falciparum infection can cause recurrent fever every 36-48 hours, or a less pronounced and almost continuous fever. Severe malaria is usually caused by P. falciparum (often referred to as falciparum malaria). Symptoms of falciparum malaria arise 9-30 days after infection. Individuals with cerebral malaria frequently exhibit neurological symptoms, including abnormal posturing, nystagmus, conjugate gaze palsy (failure of the eyes to turn together in the same direction), opisthotonus, seizures, or coma Ref Davidson 23rd edition pg 612
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