fever projr dengue 202239576 25/f

 Diagnosis

VIRAL PYREXIA WITH DENGUE IGM POSITIVE (RECOVERED)

UTI

Case History and Clinical Findings

PATIENT CAME WITH CHIEF COMPLAINTS OF

- FEVER (HIGH GRADE) SINCE 9 DAYS

-BURNING MICTURITION SINCE 9 DAYS

-NAUSEA AND VOMITINGS SINCE 9DAYS

-HEADACHE(DIFFUSE) WITH NECK PAIN SINCE 9DAYS

-BODY PAINS SINCE 9DAYS

-DRY COUGH (INTERMITTENT) SINCE9DAYS

HISTORY OF PRSENT ILLNESS

PATIENT WAS APPARANTELY ASYMPTOMATIC9 DAYS AGO.THEN SHE DEVELOPPED FEVER (HIGH GRADE) ASSOCIATED WITH CHILLS AND RIGORS,INCREASE IN TEMPERATURE AT NIGHT AND RELIEVED ON TAKING MEDICATION AND REVERTS BACK.SHE ALSO DEVELOPPED NAUSEA VOMITING 9 DAYS BACK.SHE ALSO DEVELOPPED HEADACHE(DIFFUSE) ASSOCIATED WITH NECKPAIN SINCE 9 DAYS.SHE HAVE BODY PAINS FROM 9DAYS.SHE HAD DRY COUGH(INTERMITTENT) FROM 9DAYS


BRIEF COURSE IN HOSPITAL

24 YEAR OLD FEMALE CAME TO THE CASUALTY ON 19/09/2022 WITH CHIEF COMPLAINTS OF

-FEVER (HIGH GRADE) SINCE 9 DAYS.ASSOCIATED WITH CHILLS AND RIGORS.RAISE IN TEMPERATURE SEEN AT NIGHT AND RELIEVED ON MEDICATION AND REVERTS ACK.

-BODY PAINS,HEADACHE ASSOCIATED WITH NECK PAIN SINCE 9 DAYS

-NAUSEA AND VOMITINGS SINCE 9 DAYS

-BURNING MICTURITION SINCE 9 DAYS

-DRY COUGH(INTERMITTENT) SINCE 9 DAYS

SHE WAS TESTED DENGUE IGM POSITIVE ON 14/09/2022.REQUIRED INVESTIGATIONS WEWRE DONE AND PATIENT IS SHIFTED TO AMC.INITIALLY SHE WAS ON IV FLIDS.TAB.DOXYCYCLINE WAS GIVEN FOR 4DAYS.

PAST HISTORY

-TESTED DENGUE IGM POSITIVE ON14/09/2022

-N/K/C/O DM,HTN,ASTHMA,EPILEPSY,TB,THYROID DISORDERS,CVA,CAD

GENERAL EXAMINATION

PALLOR-ABSENT

ICTERUS-ABSENT

CYANOSIS-ABSENT

CLUBBING-ABSENT

LYMPHADENOPATHY-ABSENT

EDEMA-ABSENT

VITALS

BP-100/60 mmHg

PR-132BPM

TEMP-102.2F

SPO2-99% at RA

GRBS-154 MG/DL

SYSTEMIC EXAMINATION


=>CVS-S1S2+

NO THRILLS

NO MURMURS

=>R/S-BAE+

NVBS HEARD

TRACHEA-CENTRAL

NO WHEEZE

NO DYSPNOEA

NO ADVENTITIOUS SOUNDS HEARD

=>P/A-SOFT AND TENDERNESS SEEN IN RIGHT LUMBAR REGION

SHAPE OF ABDOMEN-SCAPHOID

NO FREE FLUID

NO PALPABLE MASS

HERNIAL ORIFICES-NORMAL

NO ORGANOMEGALY

=>CNS-PATIENT IS CONSCIOUS COHERENT AND COOPERATIVE

SPEECH-NORMAL

NO SIGNS OF MENINGEAL IRRITATION

NFND

Investigation

19/09/2022

=>CBP

HB-10.7GM/DL

TLC-9600 CELLS/CUMM

N-55

L-35

M-8

RBC-3.84 MILLIONS/CUMM

PLATELETS-1.85 LAKHS/CUMM

=>RBS-130 MG/DL

=>USG ABDOMEN-MILD HEPATOSPLENOMEGALY

RIGHT KIDNEY-11.1#4CM-CMD+


LEFT KIDNEY-11.7#5CM-CMD+

UB-PARTIALLY DISTENDED

GB-PARTIALLY DISTENDED

=>CRP-1.2 MG/DL

=>BLOOD CULTURE AND SENSITIVITY-INSIGNIFICANT GROWTH

=>URINE CULTURE AND SENSITIVITY-INSIGNIFICANT GROWTH

20/09/2022

=>HEMOGRAM

HB-10.5 GM/DL

TLC-6600 CELLS/CUMM

N-64

L-27

M-9

E-0

PCV-30.8

RBC-3.74 MILLION/CUMM

PLATELET COUNT-1.51 LAKHS/CUMM

21/09/2022

=>HEMOGRAM

HB-10.7 GM/DL

TLC-7200 CELLS/CUMM

N-56

L-37

M-4

E-3

PCV-32.3

RBC-3.83 MILLIONS/CUMM

PLATELET COUNT-1.71 LAKHS/CUMM


22/09/2022

=>HEMOGRAM

HB-11.3 GM/DL

TLC-8200 CELLS/CUMM

N-50

L-40

M-7

E-3

PCV-34.7

RBC-4.07 MILLIONS/CUMM

PLATELET COUNT-2.03 LAKHS/CUMM

Treatment Given(Enter only Generic Name)

1)TAB.ZOFER 4MG PO/SOS

2)TAB.DOXYCYCLINE 100MG PO/BD

3)TAB.PCM 650MG PO/QID

4)TAB.RIBOFLAVIN 10MG PO/BD

5)SYP.CITRALKA 10ML IN 1GLASS OF WATER PO/TID

Advice at Discharge

1)TAB.DOXYCYCLINE 100MG TWICE DAILY AT 8AM AND AT 8PM

2)TAB.PAN 40MG ONCE DAILY AT 8AM (BEFORE BREAKFAST)

3)TAB.RIBOFLAVIN 10MG TWICE DAILY AT 8AM AND 8PM

4)TAB.ZINCOVIT ONCE DAILY AT 2PM

5)TAB.PCM 650MG ORALLY/SOS






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