A CASE OF DENGUE

“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 patient’s clinical problems with collective current best evidence based inputs. This e-log book reflects my patient centered online portfolio and your valuable inputs on the comments is welcome.”

A 68 year old Female patient who is a resident of choutuppal came to the OPD with

CHIEF COMPLAINTS

Giddiness

Generalised weakness since 5 days

Fever since 1day

Nausea and vomiting

Diarrhea

NS1 positive

HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic 1 week back when she developed high grade fever associated with chills and rigor along with nausea , vomiting with diarrhea

The vomiting was since 4 days non projectile and contains food particles about 4 times a day

The diarrhea also since 4 days watery with loose stools without blood

There is no pain in abdomen but the patient complained of back pain and knees pain

 
HISTORY OF PAST ILLNESS

No history of Diabetes mellitus
                    Thyroid disease
                    Bronchial  Asthma
                    Tuberculosis
                    Hypertension 
K/C/O of PSORIASIS 
only over dorsum of foot and is seasonal exaggerated during summer

PERSONAL HISTORY

Married
Appetite-Decreased
non vegetarian
Bowels-loose stools
Micturition-Normal
Addictions- occasional toddy consumer

FAMILY HISTORY

No significance

General examination

The patient is conscious coherent and cooperative

 Pallor is there

NO Icterus

NO Cyanosis

NO Koilonychia

NO Lymphadenopathy

NO Edema 

NO Malnutrition

VITALS

Temperature- 100.5 At time of admission now afebrile

BP :120/70 mmHg 

Pulse rate : 67

Respiratory rate : 17

SPO2 at room air :98% 


SYSTEMIC EXAMINATION 

CVS

NO Thrills 
S1 and S2 heard +
NO murmurs
 

RESPIRATORY SYSTEM

Position of trachea: central
NO wheeze
NO dyspnoea

ABDOMEN

Shape : Scaphoid

NO Tenderness

No palpable mass, fluid , bruits


CNS 

Normal speech

NO signs of meningeal irritation

 DIAGNOSIS
NS1 POSITIVE Viral pyrexia with Thrombocytopenia




INVESTIGATIONS

NS1 POSITIVE FOR DENGUE

Complete Blood Picture on Day 2
Complete Blood picture on Day 4


X-ray

Ultrasound



TREATMENT

DAY 1

IVF-NS

    -RL

INJ PANTOP  40   IV/OD

INJ NEOMOL 200  IV/SOS

INJ ZOFER 4 IV/SOS

Tab DOXYCYCLINE 100 PO/ BD

STRICT FEVER CHART MONITORING


DAY 2

IVF-NS

    -RL

INJ PANTOP  40   IV/OD

INJ NEOMOL 200  IV/SOS

INJ ZOFER 4 IV/SOS

TAB PCM 500  PO/ TD

MONITOR POSTURAL HYPOTENSION

W/F BLEEDING MANIFESTATION

STRICT FEVER CHART MONITORING



DAY  3

IVF-NS

    -RL

INJ PANTOP 40 IV/OD

INJ NEOMOL 200 IV/SOS

INJ ZOFER 4 IV/SOS

TAB PCM 500 PO/ TD

MONITOR POSTURAL HYPOTENSION

W/F BLEEDING MANIFESTATION

STRICT FEVER CHART MONITORING

Day 4
IVF-NS

    -RL

INJ PANTOP 40 IV/OD

INJ NEOMOL  200 IV/SOS

INJ ZOFER 4 IV/SOS

TAB PCM 500 PO/ TD

MONITOR POSTURAL HYPOTENSION

W/F BLEEDING MANIFESTATION

STRICT FEVER CHART MONITORING


Comments

Post a Comment

Popular posts from this blog

long case 2

Image
  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.                                                                                      With the help of our senior https://mvineelarollno90.blogspot.com/2023/11/65-y-female-with-co-fever-since-4-days.html I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment
Read more

Pathology

Image
CHRONIC LEUKEMIA By Munukutla Sai Mythili 88     Shwetha Mummadi 87 INTRODUCTION Leukemia is cancer that starts in the blood-forming cells of the bone marrow. When one of these cells changes and becomes a leukemia cell, it no longer matures the way it should and grows out of control. Often, it divides to make new cells faster than normal. Leukemia cells also don't die when they should. This allows them to build up in the bone marrow, crowding out normal cells. At some point, leukemia cells leave the bone marrow and spill into the bloodstream. This increases the number of white blood cells in the blood. Once in the blood, leukemia cells can spread to other organs, where they can prevent other cells in the body from functioning normally. Leukemia is different from other types of cancer that start in organs like the lungs, colon, or breast and then spread to the bone marrow. Cancers that start elsewhere and then spread to the bone marrow are not leukemia. What is a chronic leukemia? I
Read more

OSCE

Image
Hello everyone I'm mythili, an aspiring final year medical student presenting an osce report after garnering the patient informed consent Let's start off by learning the brief history about the patient A35 year old female came with cheif complaints of -Diminision of vision of right eye since morning 3am -Headache since 2 days Delving more into the history Patient was apparently asymptomatic 2 days back then started developing diffuse headache which was sudden in onset,gradually progressive associated with neckpain  No H/O nausea and vomiting,photophobia,phonophobia Then since morning 3am had sudden painless loss of vision No H/O ocular trauma or head trauma No H/O giddiness,LOC,weakness of both UL and LL No H/O fever,cough,cold,chestpain,palpitations,orthopnea,PND What was her last final diagnosis?  The final diagnosis  is CRVO Complete retinal venous occlusion  CRVO? How was the diagnosis made?  Upon opthological examination Dot blot hemorrhage Macular edema Which are characte
Read more