### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have a nephew 24 yrs old. He has been sick for several weeks with what he thought was allergies. It has gotten progressively worse with high fever of 104 nausea vomiting with chills. He has headaches and severe abdominal pain. He has been unable to keep anything down for 3 days. His first trip to the ER said it was his Gallbladder and referred him to a Surgeon. The surgeon said it wasnt his gall bladder he has sludge and its slightly enlarged but no stones. Next Dr said that he had Pneumonia and started treating him with IV ABT. Now an Internal Medicine Dr is telling us that his Lymphocytes are high and that it could be 4 things but only told us 2, Mono, or cancer. His spleen is enlarged and he has swollen lymph nodes in his neck and armpit. What do you think it could be?Thanks

### output:

Hi. Thanks for an elucidated history. What I can get from your history and findings the various Doctors gave you that your nephew is suffering from septicemia with secondary changes seen in spleen and lymph nodes. Also noted about Pneumonia, elevated WBC count and gall stone sludge would recommend the following :To undergo blood culture and sensitivity along with review CBC, sugar, Tidal for Typhoid, liver and kidney functions, ; urine and stool tests; CT scan of the chest and the abdomen to see for lymph nodes, pneumonia, gall bladder, liver, spleen and all other organs. I am sure to find out the diagnosis and get treated accordingly. He needs a strictly hospitalized treatment. Mono or Cancer may no present like this.