1702102092 LONG CASE

40 YEAR FEMALE WITH VIRAL PYREXIA WITH THROMBOCYTOPENIA.

40 year old female came to the casuality with complaints of fever 5days back which resolved and vomiting and loose stools since yesterday. 

HISTORY OF PRESENTING ILLNESS-

Patient was apparently asymptomatic 5 days back. Then she developed high grade fever not associated with chills and rigors ,  which was subsided on taking medications. She c/o vomitings since yesterday which were non bilious non projectile associated with food particles as content and complains of  loose stools 3-4 episodes in a day ,colour black ,sometimes red in colour  not associated  with pain abdomen/ vomitings. 

No history of consumption of outside food .

No similar episodes in the past .

No h/o hematuria, rashes on the body

No h/o burning micturition. 

Past history:

Not k/c/o DM, HTN, TB, asthma, epilepsy

GENERAL EXAMINATION:

Vitals: 

Temp: afebrile

PR: 110 bpm regular , normal volume 

BP: 100/60 mm hg

RR: 20 cpm



CVS: s1s2 heard

RS: BAE+ NVBS+

P/A: soft, non tender, bowels sounds heard

CNS: NFND


INVESTIGATIONS:


Hemogram:

HB: 6.8

Platelets: 40000 /cu mm


CUE: alb +++


S alb: 1.0









DIAGNOSIS:

Viral pyrexia (resolved) with thrombocytopenia

With bloody diarrhoea secondary to dysentery? Hemorrhoids?

With anemia under evaluation With thrombocytopenia with hypoalbunemia. 


TREATMENT:


IV fluids infusion @50 ml/hr

Oral fluids-2L

Inj.tranexa 500 mg iv sos

Inj.vit k 1 amp in 100 ml ns iv od

Inj.pan 40 mg iv od

Inj.optineuron 1 amp in 100 ml ns iv od

Egg whites 4/day

Tab.pcm 650 mg/po/sos

Inj.neomol 100 ml iv sos if temp greater than 101F

Inj.piptaz 2.25 mg iv tid.


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