Fever projr dengue 202404563

 Diagnosis

VIRAL PYREXIA WITH THROMBOCYTOPENIA

Case History and Clinical Findings

80YR OLD MALE CAME WITH CHIEF COMPLAINTS OF FEVER SINCE 5 DAYS AND GENERALISED WEAKNESS SINCE 5 DAYS

HISTOR OF PREENTING ILLNESS : PATIENT WAS APPARENTLY ASYMPTOMATIC 5 DAYS BACK , THEN HE DEVELOPED HIGH GRADE FEVER WITH DIURNAL VARIATION ASSOCIATED WITH HEADACHE AND NOT ASSOCIATED WITH CHILLS AND RIGORS

NO H/O COLD , COUGH , SOB , ABDOMINAL DISTENSION

NO H/O PAIN ABDOMEN , LOOSE STOOLS , NAUSEA , VOMITINGS

NO H/O BURNING MICTURITION

PAST HISTORY : K/C/O DM SINCE 1 YR ON TAB GLYCOMET GP1

H/O CHEST PAIN ? CAD 6 YRS BACK

N/K/C/O CVA , SEIZURES , THYROID , ASTHMA

GENERAL EXAMINATION-

THE PATIENT IS CONSCIOUS, COHERENT, COOPERATIVE

MODERATELY BUILT AND NOURISHED

NO SIGNS OF PALLOR, ICTERUS, CYANOSIS, CLULBBING, EDEMA

VITALS:

TEMP: 97 F

PR: 74 BPM

RR: 16 CPM

BP: 140/90 MM HG

PO2: 96% @ RA

GRBS: 320 MG/DL

CVS: S1, S2 HEARS, NO MURMURS

RS: BAE+, NVBS

TRACHEA: CENTRAL

NO DYSPNOEA AND WHEEZE

NO RHONCHI

ABDOMEN: NON TENDER, SOFT

LIVER AND SPLEEN NOT PALPABLE

BOWEL SOUNDS HEARD

CNS:

LEVEL OF CONSCIOUSNESS: CONSCIOUS, ALERT

SPEECH: NORMAL

NECK STIFFNESS ABSENT

KERNINGS SIGN ABSENT

CRANIAL NERVES: NORMAL

MOTOR SYSTEM: NORMAL

SENSORY SYSTEM: NORMAL

GCS: 15/15 E4V5M6

TONE:

UL: NORMAL

LL:NORMAL

POWER:

UL: BOTH 4/5

LL: BOTH 4/5

REFLEXES: RT LT

B: +2 +2

T: +2 +2

S: +1 +1

K: +2 +2

A: +1 +1

Investigation

HBsAg-RAPID 29-01-2024 04:32:PM Negative


Anti HCV Antibodies - RAPID 29-01-2024 04:32:PM Non ReactiveWIDAL TEST 29-01-2024 05:01:PMS.typhi 'O' Antibodies No Agglutination seenS.typhi 'H' Antibodies No Agglutination seenS.PARATYPHI 'AH' ANTIBODY No Agglutination seenS.PARATYPHI 'BH' ANTIBODY No Agglutination seen

HEMOGRAM

HB 12.7

RBC 4.26 MILLIONS/CUMM

TC 5700 CELLS/CUMM

PLT 1.20 LAKHS/CUMM

APTT 34 SEC

PT 17 SEC

INR 34

BLOOD FOR MP - NEGATIVE

FBS 117 MG/DL

UREA 49 mg/dl CREATININE 0.9 mg/dl URIC ACID # 2.4 mg/dl CALCIUM 9.8 mg/dl PHOSPHOROUS 2.7 mg/dl SODIUM 136 mEq/L POTASSIUM 4.0 mEq/L CHLORIDE 100 mEq/LTotal Bilurubin 0.81 mg/dl Direct Bilurubin 0.16 mg/dl SGOT(AST) # 50 IU/L SGPT(ALT) # 52 IU/L ALKALINEPHOSPHATE 111 IU/L TOTAL PROTEINS 6.5 gm/dl ALBUMIN 3.4 gm/dl A/G RATIO 1.09.

Treatment Given(Enter only Generic Name)

INJ IV FLUIDS NS @ 75M/HR + 1 AMPULE OPTINEURIN

INJ PAN 40 MG IV/OD

CAP DOXYCYCLINE 100 MG PO/BD

TAB DOLO 650MG PO/TID

TAB GLIMI M1 PO/OD AFTER FOOD

Advice at Discharge

CAP DOXYCYCLINE 100 MG PO/BD x 4 DAYS

TAB GLIMI M1 PO/OD AFTER FOOD CONTINUE

TAB DOLO 650MG PO/TID SOS

PLENTY OF ORAL FLUIDS

WATCH FOR BLEEDING MANIFESTATIONS






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