Viral fever

   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 series of inputs from available global online community of experts with an aim to solve those clinical problems with collective current best evidence based inputs                  

25 yr old female patient resident of miryalguda,housewife by occupation came to OPD with chief complaints of fever since 5 days and giddiness since 5 days.


History of presenting illness:

Patient was apparently asymptomatic 5 days back the she developed fever  which is sudden in onset, continuous ,high grade fever, associated with chills and rigors relieved on medication .
Fever is associated with headache,retro orbital pain.
History of generalized weakness, body pains.
History of nausea and vomitings(non bilious) 3 to 4 times a day projectile
History of cough (non productive)
History of abdominal pain, burning micturition .


Past history:

 no similar complaints in the past
Not a know case of diabetes, hypertension,asthma ,Tb, cardiovascular disease , seizures, thyroid problems.


Treatment history: 

Undergone blood transfusion during cesarean section due to heavy blood loss

Surgical history:

Undergone 3 cesarean sections

Personal history:

Diet-mixed
 Appetite-normal 
Bowel -regular
Burning micturition
No addictions
No allergis to food drugs

Family history: not significant

Menstrual history: 

Age of menarche 13yrs
Cycles regular
Normal flow

Physical examination: 

Patient is conscious coherent co operative and well oriented to time place person
Moderately built 
Moderately nourished
No history of pallor ,cyanosis , clubbing,lympedenopathy,pedal edema

Vitals :
Bp:90/60mm hg 
RR:20cpm
Pulse rate:78bpm
Temp:99.5c

Systemic examination:

CVS
S1 n S2 heard 
No murmurs

Respiratory system:
Trachea central 
Bilateral air entry present 
Vesicular breath sounds heard
No wheeze or other adventitious sounds

Per abdomen examination
Shape of abdomen : scaphoid
Umbilicous Central no scars sinuses visible pulsations engorged veins
No local rise of temperature
Tenderness present
No palpable mass 
No oragnimegaly
Bowels sounds present

CNS examination 

Conscious, gait normal
Normal speech 
No meningial signs like neck stiffness
Reflexs:    biceps   triceps supinator knee ankle 
Rgt.        All are present
Lft.




Investigations














Provisional diagnosis: viral pyrexia with thrombocytopenia


Treatment:
Iv fluids -DNS
Ringer lactate 
Inj.pan 40 mg iv/of
Inj.zofer 4mg iv /tid
Monitoring vitals.


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