20 year old male with fever and body pains.

A 20 year old male with fever and body pain

Date of admission: 22-09-2022

HOPI:-

Patient was Apparently asymptomatic 1 week back then he developed fever with chills which is high grade ,sudden in onset & associated with body pains .Relieved on medication.

No h/o Loose stools, vomitings,N

PAST HISTORY:-No HTN,DM, Thyroid, Epilepsy.

PERSONAL HISTORY:-

diet- mixed

Appetite- normal

Sleep- adequate

Bowel and bladder movement- normal

GENERAL EXAMINATION:-

Patient was conscious, coherent, cooperative,well oriented to time place and person.

Moderately built & moderately nourished.

No pallor,Icterus,cyanosis, lymphadenopathy, clubbing.

Vitals:

BP -90/60mmhg

PR -84

RR -14cpm

Spo2 -99

Temp:-99.5 

PROVISIONAL DIAGNOSIS:-DENGUE WITH THROMBOCYTOPENIA.




INVESTIGATIONS:-

DAY- 1

DAY- 3
DAY -4

 TREATMENT:-

1) Iv fluids NS @ 100ml/hr

2) Tab DOLO 650 mg Po/TID

3) INJ PAN 40 mg IV/OD

4) INJ NEOMOL IV/ SOS( IF TEMP >101 F

5) INJ ZOFER 4mg IV/SOS

6) BP AND TEMP MONITERING









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