A TYPICAL VIRAL PNEUMONIA MASQUERADING AS A TROPICAL ILLNESS

Abstract

We present a case of a 1 4-year-old female from Mumbai who was referred to Tirunelveli Medical College and Hospital (TVMCH) with a 1 4-day history of high-grade intermittent fever, followed by progressive breathlessness and non-productive cough. Initial investigations revealed thrombocytopenia, anaemia, and lymphocytosis. CT chest demonstrated bilateral pleural effusion and multifocal patchy air-space opacities consistent with atypical/viral pneumonia (Jain et al., 201 5; Mandell et al., 2007). CT abdomen showed mild ascites and gallbladder wall oedema. Serological workup was negative for dengue, leptospirosis, and scrub typhus; Widal test showed raised titres for Salmonella typhi (Wain et al., 201 5). The patient was managed with supportive care including oxygen therapy, IV fluids, antibiotics, and blood product transfusions, with gradual clinical and haematological improvement. This case highlights the diagnostic challenges posed by prolonged fever with multisystem involvement in a paediatric patient and underscores the importance of systematic evaluation and timely imaging.