GM CASE DISCUSSIONS.

40 year old male came to casualty  with c/o fever, cough with blood tinged sputum(1 episode),red coloured urine associated with B/L loin pain. 

HISTORY OF PRESENT ILLNESS :
Patient was apparently asymptomatic 1week back then he developed  fever, insidious in onset, no diurnal variation, subsided on taking medication for 2-3 hrs.H/o burning micturition since 2-3 days.H/o passage of red coloured urine after taking medication (?suggested COVID tablets).  H/o cough with blood tinged sputum since yesterday.H/o  B/L loin pain,non radiating. 

PAST HISTORY :
Not a k/c/o DM/HTN/ASTHMA/EPILEPSY/TB

PERSONAL HISTORY :
appetite-normal
Sleep-adequate
Bowel and bladder-burning micturition
Addictions-1bidi/day since 30 years. 

No significant family and treatment history. 

GENERAL EXAMINATION :
pt. is c/c/c
TEMP:Afebrile
BP:110/80 mm Hg
PR :78 bpm
Nopallor,icterus,cyanosis,clubbing,lymphadenopathy,edema.
SYSTEMIC EXAMINATION :
CVS:S1,S2 heard
RS:BAE + 
P/A: soft, non tender
CNS: NFND

PROVISIONAL DIAGNOSIS :
DENGUE FEVER(NS1 POSITIVE ) WITH LEFT LUNG  ?CONSOLIDATION WITH GLOMERULONEPHRITIS. 

PLAN OF CARE:
IVF-NS, RL@100ml/hr
INJ. CEFTRAIXONE 1GM/IV/BD
INJ. DOXY 100MG/IV/BD
INJ. PAN 40MG/IV/OD
SYP. ASCORYL. LS. PO/BD(100ML)
NEBULIZATION WITH DUOLIN -8TH HOURLY  AND BUDECODT-12TH HOURLY. 
O2 INHALATION TO MAINTAIN SPO2 92%
BP/PR/TEMP CHARTING 6TH HOURLY. 


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