Dengue with thrombocytopenia

 Dengue with thrombocytopenia. 

Name: Raveela 

Roll no. 95

ICU bed no 3.

Under the guidance of

28yr old male resident of nalgonda came with the chief complaints of fever since 5days ,pain abdomen since 2days . 

NS1+ve , 

platelets 23000


HOPI;

Fever since 5days high grade intermittent relived on medication, pain abdomen difuse, history of vomiting 1episode 5days back which is non bilious and non projectile. 

No history of cough, loose stool, sob. 

Went to the local hsptl and tested dengue NS1+ve, and bought to our hsptl with low platelet count (23000). 

Past history;

No h/o DM/HTN/ASTHMA/EPILEPSY/TB.

PERSONAL HISTORY

Farmer by occupation

Appetite-decreased

Regular bowel and bladder movements

No addictions 

On Examination;

No signs of pallor, icterus, clubbing, cyanosis, lymphadenopathy, edema. 

VITALS ;

temp:101 F 

PR: 88bpm

RR: 20/min

BP :110/70 mm /hg

Spo2: 98

GRBS:95mg %

SYSTEMIC EXAMINATION;

cvs :s1s2 heard

RS :NVBS


PA: soft, and tenderness present in right hypochondriac region. 

CNS:NFAD

INVESTIGATIONS:

HB :14 

TLC:6900

PLATELETS ;23000

PCV :39.6

MCV:80.8

MCHC:35.4

RBC:4.9 

blood group typing A+ve 

blood sugar 108 

blood urea 23

CUE: 

pale yellow color

Albumin ++ve

Sugars nill

Pus cells 3-4

Serum electrolyte:

Na:12.5

K+:4.5

Cl: 91 

Sr. Creatinine 0.8

LFT:

TB:1.4

DB :0.8

AST :43.1

ALT:103

ALP:147

ECG:


Xray:




PROVISIONAL DIAGNOSIS:

DENGUE WITH THROMBOCYTOPENIA. 

TREATMENT:

IV fluids Ns and RL100ml/hr

Tab:dolo 650mg tid

Inj;pan 40mg IV

Inj:optineuron 1amp in 100ml ns

Inj:neomol 1gm IV 

Temp monitor 

W/f bleeding manifestions

DAY 2:

 soap notes :

S;  

fever spikes seen , abdominal tenderness present in right hypochondriac region, mild blood in sputum and in urine. 

O:

BP 120/80mm/hg 

PR:81

TEMP:103

RESPIRATION 17CYCLES 

CVS :S1 S2 heard

RS: decreased movements on right side and Inspiratory crepts on supra clavicular region. 

PA:tender abdomen in right hypochondriac region. 

USG REPORT:



HB 13.8

TLC 4200

N -64

L-30

PCV -39.2

PLATELETS -30000

Brief case history by: alekhya mam. 

http://alekhya09.blogspot.com/2021/10/28-yr-old-male.html

















Popular posts from this blog

Medicine Case Discussion

  Online Blended Bimonthly assignment towards summative assessment for the month of May 2021 Pulmonolgy 1) A 55yr old female with Shortness of breath,pedal edema and facial puffiness.  A) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem? Ans:At the month of january that year during which time she was working in a paddy field. For the next 8 years the patient has suffered from similar episodes of SOB every year each lasting aproximately 1 week For the past 12 years she has been having an yearly episodes now lasting around a month again around january. Until her latest episode the SOB was of grade II Her latest episode of shortness of breath started 30 days ago, her SOB was insidious in onset and gradual in progression. Initially the SOB occurred on exertion and was relieved upon rest. From 2 days ago she started having SOB even a
Read more

45 yr /F Paraparesis secondary to Trauma with disphagia

 C/O Generalized weakness of lower limbs since 10 years Difficulty in swallowing since 15 days  HOPI: Pt was apparently asymptomatic till 1999 then she delivered a baby(by c-section due to cord entanglement) she also stated that she started developed Generalized weakness ( due to low haemoglobin levels ) not associated with pain and was able to perform her daily activities Her husband also left as she couldn't perform her daily activities.Her son currently stays in the hostel   She previously used to work as mandal officer. And in 2012 she stopped going to work because she started developing weakness insidious in onset , gradually progressive , associated with pain , Aggrevated with walking and relieved with rest. she could not walk for long distances and she managed to to perform daily activities In 2023 Jan she alleged had h/o slippage in bathroom following which she was normal for 5 days  Next day she couldn't get up from bed which is sudden in onset and non progressiv
Read more