24 YRS OLD MALE COMPLAINTS OF FEVER SINCE 1WEEK

 24 yrs old male complaints of fever since 1 week, black coloured stools since 2 days, giddiness since 1 day

Patient came with c/o high grade fever since 1 week associated with chills intermittent,went to RMP and took some injections later fever subsided 1 day ago

C/o black coloured stools since 2 days

C/o giddiness since 1 day.

No c/o vomiting,loose stools,cold, cough, shortness of breath, burning micturition,rashes, body pains.


Past History:- not a k/c/o DM,HTN,CAD.

Vitals:-

Temp- 98.3oF

PR- 98bpm

RR- 20 cpm

BP- 110/80 mmHg

Spo2- 98% at RA

General examination:-

Patient is conscious, coherent, cooperative

No signs of Pallor, Icterus, Cyanosis, Clubbing, Lymphadenopathy or Edema.












Systemic examination:-

CVS-s1s2+

RS- BAE+,NVBS

CNS- NAD

P/A-soft , non tender,BS+

Provisional diagnosis:- 

Dengue fever with thrombocytopenia( NS +)


INVESTIGATIONS:-


X-ray:



Ecg:



USG:














TREATMENT:-

1 IVF NS,RL,DNS- @100 ml/hr.

2 Inj pantop 40 mg IV OD

3 W/F postural hypotension, bleeding manifestations

4 tab doxycycline 100 mg po BD

5 Inj optineuron 1 amp IV OD in 100 ml DNS

6 BP,PR 4th hourly

7 Temp charting 4th hourly

8 GRBS 12th hourly.












Comments

Post a Comment

Popular posts from this blog

65yrs old male patient came to casually with c/o shortness of breath and pedal edema

Image
A 65 yr old male was brought to casualty with c/o SOB since 5 days, pedal edema since 20 days.   Patient was apparently asymptomatic 5 years back - was diagnosed with hypertension and diabetes when he visited a local hospital for fever. 6 to 7 months back - He started to experience Dyspnea, which was sudden onset, progressive. He also complained of orthopnea. He was diagnosed with CAD and he underwent at CAG on 19/10/2021 which reveled single vessel disease - LAD territory. The patient also underwent renal angiogram and and was found to have bilateral renal artery stenosis with 90% of Left renal artery to be stenosed and was advised renal artery stenting. He also had OM3 70% stenosis, proximal LAD 50 %, right renal artery 50%, left renal artery 90% stenosis.  PTCA with OM2 and PTRA to left renal artery was done on 12/11/21. Since 15 days he has SOB. patient presented with SOB grade 3-4 and pedal edema since 20 days. Abdominal distension present.  Patient was chr...
Read more

55 yrs old male patient with came with cheif complaints of abdominal pain since 5 days and chest pain since 2 days

Image
 Patient came with cheif complaints of abdominal pain since 4 days and chest pain since 2 days. Patient was apparently asymptomatic 1 week back and then he consumed alcohol(650ml)  for 2 days continuously and he developed abdominal pain which is dragging type,non radiating, associated with altered sensorium. C/o chest pain dragging type,non radiating to left arm. C/o vomiting 3 days back . Past history:- Patient is k/c/o DM since 2 yrs and on oral hypoglycemic drugs. Personal history:- Alcohol consumption since 30 yrs and currently consumes 650 ml of alcohol daily. On examination patient is conscious, irritable Vitals:- BP- 120/70 mmHg PR-111bPm Spo2- 99%at RA. GRBS-  5:30-600 7:30- 390 8:30-380 9:30- 383 10:30- 382 11:30- 260 12:30- 210 1:30- 220 2:30- 206 3:30- 207 4:30- 147 5:30- 77 6:30- 121 7:30- 131 Systemic examination:- CNS- patient is in altered sensorium, irritable and irrelevant talk INVESTIGATIONS:- Treatment:- 1. IVF- NS- 1L for 3hrs. 2. Inj HAI 6IU IV/STAT. ...
Read more

75 yrs old male came to casuality with c/o SOB on exertion and cough

Image
 GENERAL MEDICINE CASE "This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome 75yrs old Male came to casuality with c/o SOB On exertion since 1 month, aggravating since 7 days. C/o cough with expectoration since 1 month C/o pedal edema since 7 days HOPI: Pt was apparently asymptomatic 1 month back then he developed SOB on exertion( Grade 3) associated with cough with expectoration since 1 month.Pedal edema since 7 days, gradually progressive. No h/o decreased urine output, abdominal distention No h/o fever , vomitings, diarrhoea....
Read more