DOI: 10.36347/sjmcr.2015.v03i03.021

Pages: 249-251

A 5 years female child was admitted with prolonged fever and rash of 3 week. On history systemic onset juvenile idiopathic arthritis (SOJIA) was one of the possibilities but positive widal titer shifted our diagnosis to typhoid fever. After some day she developed circulatory failure with respiratory distress with IgM positive dengue titer from which she survived with supportive care. During this episode we reviewed whole case again and able to reach the correct diagnosis of SOJIA with possibility of macrophage activation syndrome (MAS).