40yr Female with Fever and Thrombocytopenia

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PRESENTING COMPLAINTS:

C/O FEVER SINCE 4DAYS,

COLD SINCE 4DAYS,

COUGH WITH SPUTUM SINCE 4DAYS,

GENERALISED BODY PAIN SINCE 3DAYS,

HEADACHE SINCE 3DAYS,

VOMITINGS SINCE 1DAY.


HISTORY OF PRESENTING ILLNESS:

PATIENT WAS APPARENTLY ASYMPTOMATIC 4 DAYS BACK THEN PATIENT DEVELOPED COLD AND FEVER ,HIGH GRADE, INTERMITTENT,ASSOCIATED WITH CHILLS AND RIGOR,RELEIVED ON MEDICATION.

COUGH SINCE 4DAYS ,PRODUCTIVE, WHITE COLOUR, SCANTY AMOUNT

GENERALISED BODY PAINS SINCE 3DAYS AND HEADACHE SINCE 3DAYS, NAUSEA SINCE 1DAY

VOMITINGS SINCE 1DAY 3EPISODES,NON-PROJECTILE,NON-BILIOUS,FOOD AS CONTENT.

NO H/O CHEST PAIN, BURNING MICTURATION,SOB,ABDOMINAL PAIN

NO H/O BLACK COLOURED STOOLS


HISTORY OF PAST ILLNESS:

NOT K/C/O DM,HTN,ASTHMA,CAD

K/C/O TB 10YRS BACK (COMPLETED 6MONTHS COURSE)


PERSONAL HISTORY:

Diet- Mixed

Appetite- DECREASED

Sleep- Adequate 

Bowel and Bladder movements- Normal.


GENERAL EXAMINATION:

PATIENT IS CONCIOUS,COHERENT,CO-OPERATIVE 

NO PALLOR,ICTERUS, CYANOSIS, CLUBBING, LYMPHADENOPATHY, EDEMA.





TEMPERATURE- 104F

BP- 110/70mmhg

PR- 108bpm

RR- 32cpm

SpO2- 97% AT ROOM AIR

GRBS-222@ ADMISSION


SYSTEMIC EXAMINATION:

CVS:

S1 S2 heard 

No cardiac Murmurs

Respiratory system :

No dyspnea 

No wheeze

Trachea position -Central 

Breath sounds -vesicular 

CNS:

No focal and neurological deficits
HMF -Normal
Pupils- Bilateral PSNL

                      Upper limb                        Lower limb


               Right             Left                  Right          Left


Tone:      Normal        Normal            Normal      Normal


Power:           5/5           5/5                   5/5              5/5


Reflexes:         Right             Left


Biceps              +                    +


Triceps            +                     +


Supinator         +                    +


Knee                +                   +


Ankle               +                  +


Plantar         Flexion        Flexion


LAB INVESTIGATIONS:

On DAY 1:





On DAY 2:


On DAY 3:


On DAY 4:


On DAY 5:


USG Abdomen:


PROVISIONAL DIAGNOSIS:

Dengue fever (NS1 positive) with Thrombocytopenia.


TREATMENT:

IV fluids NS @100ml/hr

INJ. NEOMOL 1g IV/SOS

TAB. DOLO 650mg PO/TID

TAB. PANTOP 40mg PO/OD

Plenty of oral fluids 


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