A 45 yr old lady with dengue- thrombocytopenia

 21/08/2022

Eblog3

 

Hi, I am shaik karishma , 3rd Sem Medical Student.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 patient's clinical problems with collective current best evidence based inputs. 

This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.”

I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. 

CHIEF COMPLAINTS : 

Patient was suffering with fever, chills, headache and generalised body pains since 10 days and short of breathe since 5 days and the fever was intermittent when she was on medication and weakness since 10 days.

HISTORY OF PRESENT ILLNESS:

Patient was apparently asymptomatic 10 days back then she developed fever along with chills which was intermittent in nature and relieved on medication and also she had headache and generalised body pain.since 5 days patient had shortness of breathe on exertion which has gradually progressed now to grade 2 or 3. She had abdominal pain while doing work.

PAST HISTORY:

Last year she had uterine swelling and was on mediciation for few months which is now completely alright

She had no similar symptoms in past 

No complaints of chest pain,palpitation and syncobal attacks 

No pedal edema

No burning miturition 

No decreased urine output

NO SIGNS OF ANY BLEEDING MANIFESTATIONS

No hypertenion 

No DM

No TB

No asthma

No CAD 

No surgeries in past

No chemotherapy in past

No blood transfusio

PERSONAL HISTORY

Married

Occupation: farmer

Lost appetite 

Mixed diet 

Regular bowel movement

No history of allergies

Non alcoholic

FAMILY HISTORY

no DM 

No hypertension 

No heart disease 

No cancers

No TB

No stroke 

No asthma 

GENERAL EXAMINATION 

conscious

Coherent

No pallor 

No icterus

No cyanosis 

No clubbing of fingers 

No lymphadenopathy 

No edema of feet

No malnutrition 

No dehydration 

VITALS 

BP 110/70 mmhg

HR 99 bpm

temperature 98'F

Respiration 34

SpO2 96

Random blood sugar 122


SYTEMIC EXAMINATION 

CVS 

No thrills 

S1 S2 present 

No cardiac murmers 

RESPIRATORY

Shortness of breathe

No wheezing 

Centrally placed trachea

ABDOMEN

scaphoid shape 

No tenderness

No palpable mass

Normal hernial orifices

CNS 

conscious 

Normal speech 

No neck stiffness

No kerning sign

Cranial nerves normal

Motor system normal

Sensory system normal

Glassgow scale normal


INVESTIGATIONS










 



PROVISIONAL DIAGNOSIS
dengue- thrombocytopenia 
Polyserositis

MEDICATION 
Dolo 650mg 
Neomol 150 IV
Doxy 100mg 
Flacigo 120 mg IV 





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