Case history-10

 A 19yr OLD MALE WITH DENGUE THROMBOCYTOPENIA 

Date of admission:8/12/21

A 19 yr old male came to the opd with the chief complaint of fever since three days and cough (dry) since three days .


HISTORY OF PRESENT ILLNESS:

The patient was apparently asymptomatic three days ago and then developed high grade fever associated with chills ,intermittent since 3 days ,associatied with dry cough since 3 days and generalised bodypains since 2days and history of burning micturation since 3days ,nausea ,cold,neck pain ,and constipation since 3days .


 HISTORY OF PAST ILLNESS:

No h/o vomitings ,loose stools 

Not a k/c/o HTN/DM/TB /ASTHMA /CAV/CDA 


PERSONAL HISTORY:

UnMarried ,normal appetite,non vegetarian,regular bowel movement,micturation -normal ,no known allergies ,addictions occasionally .


 FAMILY HISTORY:

No history of diabetes, hypertension, heart disease, stroke, asthma, tuberculosis,cancers .


General examination:

The patient is conscious, coherent, cooperative  .

Palar-present 

No cyanosis 

No lymphadenopathy 

malnutrition -present 

No dehydration 

No clubbing 

No icterus 

No Edema 

VITALS :

Temp :afebrile 

Pulse rate:108/min 

Respiratory rate:18cpm 

Bp:150/90mm/hg 

Spo2-99%of o2




SYSTEMIC EXAMINATION:


CVS  :

No thrills 

No cardiac murmurs 

Cardiac sounds-s1,s2 heard 


RESPIRATORY SYSTEM :

Dysponea-present 

No wheeze 

Position of trachea-central 

Breath sounds-vesicular 

ABDOMEN:

Shape of abdomen-scaphoid 

No tenderness 

No palpable mass 

Hernial orifices-normal 

No free fluid 

No bruits 

Liver ,spleen-not palpable 

Bowel sounds -yes 

CNS:

Conscious 

Normal speech 

No neck stiffness 

No kernings signs 

Cranial nerves ,motor and sensory system,glasgow scale -normal .




Provisional diagnosis:

Dengue fever with thrombocytopenia 

INVESTIGATIONS:

8/12/21







TREATMENT:

-IVF : NS, RL, DNS @100ml/hr containers.
-Inj.PANTOP 400mg IV
-Plenty of oral fluids
-Inj.zofer 4mg IV TID
-Watch for any bleeding manifestation  and postural hypertension.
-syp . CREMAFFIN 10ml po h/s
- Inj NEUMOL 1 gm IV 
-Tab DOLO 650 mg po TID 
-Tab ULTRACET 1/2 tab SOS (if headache)
- strict temp charting 4th hrly 
- W/F POSTURAL HYPERTENSION.

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