50YEAR OLD FEMALE WITH FEVER, THROMBOCYTOPENIA

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CASE PRESENTATION:

A 50 year old female came to casualty with c/o

Fever since 7 days 

HOPI:

Patient was apparently asymptomatic 7 days back then she developed fever which is of high grade,intermittent, not associated with chills and increased during night.2 days later She went to a local hospital where she was diagnosed with typhoid.she was on medication. Her platelets count reduced and fever is not subsided. 

She also complained of mild head ache since 4 days ,relieved on medication 

No h/o nausea, vomiting 

No h/o loose stools/constipation 

No h/o pain abdomen

No h/o Burning micturition 

PAST HISTORY:

Not a K/C/O DM/HTN/ASTHMA/EPILEPSY/CAD/CVA

Personal History :

Diet : mixed

Appetite : Normal 

Sleep : Adequate 

Bowel movements : Regular 

Bladder movements : Regular 

On Examination :

Patient is conscious, coherent and cooperative.

Pallor -Absent

Icterus -Absent

Cyanosis -Absent

Clubbing -Absent

Lymphadenopathy -Absent

Edema -Absent

VITALS :

AT THE TIME OF ADMISSION :

TEMP. : 98.6

PR : 88 BPM

RR : 16 CPM

BP : 100/60 MM HG

SpO2 (on Room air) : 98%

GRBS:108 GM/DL

On Systemic Examination:

CVS : S1, S2 heard

RS : BAE present 

P/A : soft, Non tender

CNS : HMF Intact

INVESTIGATIONS 

PROVISIONAL DIAGNOSIS:VIRAL PYREXIA WITH THROMBOCYTOPENIA 

TREATMENT:

1.IV FLUIDS NS@70 ML /HR

2.TAB.PCM 650 MG/PO/TID 

3.INJ.PAN 40 MG/IVBD

4.INJ.ZOFER 4MG/IV/SOS

5.INJ.NEOMOL 1GM/IV/SOS

6.VITALS MONITORING