Gm case 3
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Monday, 28 September 2021
Case of 17y/M with viral pyrexia(NS1+ve) and thrombocytopenia
17 yr old male came to casualty with c/o
Fever since 4days
Generalized weakness since 4 days
Vomtings since 3 days
HOPI:-
patient was apparently asymptomatic 4 days back had his dinner and went to sleep and developed fever with body pains which on medication relieved till next day after lunch he developed vomiting non projectile food in content and later got fever
From last 2 days he had vomitings 3 episodes/day and high grade fever associated with chills and rigor , bodypains, headache, and weakness after he went to the local rmp where he prescribed saline infusion
Today in the morning he had 2 episodes of vomitings and presented to the casualty
On examination :
Pt is c/c/c
No signs of pallor, icterus, cyanosis, clubbing, lymphadenoapathy, edema
Vitals:
Afebrile
PR: 92 bpm, regular
RR: 26 cpm
BP: 100/70 mmHg
SPO2:
AT ROOM AIR-96%
GRBS:126 mg/dl
Systemic examination :
CVS:S1,S2 heard
Apex beat:5th ICS
Resp:
BAE+(vesicular breath sounds)
Nvbs heard
Position of trachea- central
P/A: obese, tenderness absent, bowel sounds heard
Cns: NFND
Diagnosis-
Dengue fever with thrombocytopenia
Treatment given
1. IVF NS,RL @150ML/Hr
2. Inj. Pantop 40mg IV/TID
3. Inj. Optineuron 1amp in 100ml NS slow IV/OD
4. Syp. Mucaine gel 10ml-10ml-10ml
5. Check for postural hypotension/bleeding manifestations 2nd hrly
6. Temp charting
7. I/O Charting
Investigations:-
1.Sr.Electrolytes
Na+. 139
K+. 4.9
Cl-. 99
2.Sr. Creatinine- 0.9
3.LFT
Tb-1.04
Db-0.24
Ast-112
Alt-40
Alp-261
TP-5.9
ALBUMIN-3.5
A/G- 1.49
4. Hemogram
Hb-16.4
TLC-2900
N-50
L-40
E-02
B-00
PCV-47.5
MCV -86.2
MCH -30.3
RBC.-5.51
PLT-20,000
5. Blood urea-20
6. RBS-83
7. Dengue NS1 -positive
Petechiae on left side of chest
ECG
ii
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