Discriminating clinical features

• Malaria: identification of parasites on thick and thin blood films.

• Trypanosomiasis: parasites seen on blood film, lymph node biopsy or blood cultures.

• Typhoid: blood culture, faecal and urine culture and BM culture.

• Infective endocarditis: cardiac signs and blood cultures.

• Tuberculosis: AFB seen and cultured in sputum, EMU, blood or BM, tuberculin positivity on intradermal challenge, caseating granulomata on biopsy of affected tissue or BM.

• Brucellosis: blood cultures and serology.

• Hodgkin's: lymphadenopathy, hepatosplenomegaly, eosinophilia, biopsy of node or BM.

• MDS: typical dysplastic features on blood film or BM (see p218).

• AML (M4 or M5): monoblasts on blood film and BM biopsy. Skin and gum infiltration common, see p150.

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