Case Study 4
September 27 , 2021
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September 27 , 2021
A 40 year old man farmer by occupation presented to OPD with high fever and SOB
HISTORY OF PRESENT ILLNESS
Patient was apparently asymptomatic 1week back then developed fever with shortness of breath during night times and weakness then he went to near by rmp doctor and used the medication given by him and then they reached hospital in nalgonda where they consulted kims. He also have burning mictirition , blood in urea and blood while coughing since 2 days and he's unable to sleep properly during night times due to SOB.
PAST HISTORY
Not a known case of Diabetes mellitus , hypertension, asthma , epilepsy and tuberculosis.
PERSONAL HISTORY
Sleep - Inadequate
Appetite is lost
Bowel and bladder movement - Burning mictirition
Addictions - 1 bd packet/day since 30 years and occasional alcoholic.
FAMILY HISTORY
No significant family history
ON GENERAL EXAMINATION
Temperature - Afebrile
Pulse rate - 88 bpm
Blood pressure - 110/70 mmHg
SpO2 - 98% on Room Air
Respiratory Rate - 16 cycles per minute
No Pallor , cyanosis , icterus and lymphadenopathy
No clubbing of fingers and toes
No edema is present
SYSTEMIC EXAMINATION
CVS:
No thrills
No murmur
S1 S2 heard
RESPIRATORY SYSTEM:
Dyspnea
Trachea is in central position
Bronchial artery embolism
Vesicular breath sounds heard
PER ABDOMEN:
Soft
Non tender
Abdomen is Scaphoid in shape
No palpable mass
No bruits
Liver not palpable
Spleen not palpable
Bowel sounds heard
CNS:
No focal neurological deficits
PROVISIONAL DIAGNOSIS
DENGUE FEVER(NS1 POSITIVE ) WITH LEFT LUNG ?CONSOLIDATION WITH GLOMERULONEPHRITIS.
REPORTS
ECG:
CHEST X RAY:
CBP:
Hemoglobin - 14.4 g/dl
TLC - 11,500
Platelets -
Peripheral smear - Normocytic,normochromic blood picture with neutrophilic
RENAL FUNCTIONAL TEST:
Blood urea - 60
S Creatinine - 1.4
Sodium - 140
Potassium - 4.1
Chloride - 96
LIVER FUNCTION TEST:
TB - 1.08
DB - 0.27
AST - 56
ALT - 19
ALP - 154
Albumin - 2.6
TP - 4.3
A/G - 1.02
NS1 - Positive
TREATMENT
●Is there any relation between blood in cough and dengue ?
●why there is blood in urine ?
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