Dengue case

 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through a series of inputs available global online community of experts with the aim to solve the patient's clinical problems with the collective current best evidence based inputs. This E-log book also reflects my patient centred online learning portfolio and your valuable inputs in the comments section.

13 YEAR OLD BOY COMPLAINTS OF HIGH GRADE FEVER SINCE 4 DAYS

A 13 year old school going boy complaints of 

- high grade fever since 4 days

- vomitings since 4 days

- giddiness since 4 days

- loose stools since 1 day

Patient was apparently asymptomatic 4 days back then he developed fever associated with chills.

Complaints of vomiting since 4 days- 2-3 episodes/day with food particles as content

Loose stools- 5 episodes in the past one day

No history of burning micturion, rashes, bleeding gums, hematuria


VITALS

Temp- 98.8 F

PR- 90 bpm

BP- 100/60 mmHg 

RR- 18 cpm

Spo2- 98% at RA

GRBS- 118mg%

GENERAL EXAMINATION

Patient is conscious, coherent and cooperative. 

No signs of Pallor, Icterus, Cyanosis, Clubbing, Lymphadenopathy or Edema.








SYSTEMIC EXAMINATION

CVS: S1 S2 heard, no murmurs/thrills

RS: position of trachea central

Palpation of Abdomen: Soft, non tender. Liver and Spleen not palpable. Bowel sounds heard.



PROVISIONAL DIAGNOSIS

NS 1 + DENGUE


INVESTIGATIONS

Outside Reports:

Platelets- 102000 lakhs/cu.mm


8/12/21 

Hb- 15.6 mg/dl

TLC- 2,300

PLT- 45,000

BGT- AB POSITIVE

BLOOD MALARIAL PARASITE- NEGATIVE

RBS- 110 mg/dl

DENGUE NS1 +


Serum Urea- 13

Serum Creatinine- 0.6

Na- 135

K- 3.0

Cl- 96


Total Bilirubin- 0.40

Direct Bilirubin- 0.18

Aspartate aminoTransferase- 10

Alanine aminotransferase- 9

Alkaline phosphatase- 110

USG ABDOMEN


 ECG


CHEST XRAY




TREATMENT

1. IVF NS, RL, DNS @100ml/hr continuous
2. Inj PANTOP 40 mg IV OF
3. Plenty of oral fluids
4. Inj ZOFER 4mg IV TID
5. W/F Bleeding manifestations, postural hypotension
6. ORS sachets in 1 litre of water, 200 ml after each stool
7. Tab DOLO 650 mg PO SOS
8. Inj NEOMOL 1g IV SOS (if temp>101.1 F) 
9. Temp chatting fourth hourly
10. BP/PR chatting fourth hourly
11. Syp GRILINCTUS LS 10 ml PO BD
12. Syp POTCHLOR 10 ml in glass of water PO BD

Comments

Comments

  1. Kandha PrasathMarch 29, 2022 at 4:10 AM

    Thanks for sharing online E-log about dengue disease. It was quite informative.
    General Physician Coimbatore

    ReplyDelete

Post a Comment

Popular posts from this blog

prefinal exam paper

Image
  1. Define heart failure. Etiology and clinical features of heart failure? How do we diagnose heart failure clinically ,physical examination and various modalities used in diagnosis of heart failure. Write a brief note of heart failure 2. Define cirrhosis of liver. Etiopathogenesis of cirrhosis . Write a brief note on clinical features, diagnosis and treatment of cirrhosis of liver 3. Elaborate on clinical features and Diagnostic modalities of renal calculi 4. Etiology of pleural effusion. Diagnostic criteria of pleural effusion 5. Diagnosis and treatment of dengue fever 6. Clinical features and diagnosis of peptic ulcer disease 7. Treatment of pyelonephritis 8. Treatment of abdominal tuberculosis 9. Etiology and treatment of pneumonia 10. Complications of dialysis 11. Ascitic fluid analysis 12. Proton pump inhibitors 13. Afterload reducing agents in heart failure 14. Treatment of urinary tract infection  16. Insulin therapy in diabetes mellitus 17. Antihypertensive drugs in chronic r
Read more

Prefinal Practical

Image
  This is an online e log book to discuss our patient's de-identified health data after taking his/her/guardian's  signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs.  CASE :  Date of admission- December 17, 2021 A 29 years old male resident from west bengal came to the opd with chief complaints of pain in abdomen since 4 months with frequent vomiting. CHIEF COMPLAINTS: - burning sensation in abdomen and pain (weekly once or twice)  - Burning micturation with decreased urine output - Constipation  - Vomitings H/o present illness- - Patient was apparently asymptomatic 4 months back and then he had a burning type of pain in abdomen(epigastrium) radiating to the chest and then with frequent vomitings, 2-3 times per day after taking meals. - He had a burning micturition and wh
Read more