A 33y old male patient with dengue fever.



 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. 

CASE PRESENTATION:

A 33y old male patient came to opd with c/o 

1.fever with chills since 5 days 

2.C/o pain in abdomen since 4 days

Patient was apparently asyptomatic 5 days back , 

later he had fever which was insidious in onset,progressive,high grade and a/w chills,intermittent type with no diurnal variations,no aggregating or relieving factors

Fever was followed by 2-3 episodes of vomitings with contents of food particles,non foul smelling,non bilious,non projectile

Later pt had pain in abdomen which was diffuse in nature, dragging type of pain.Pain aggravated on consuming food .h/o passing flatus and red coloured stools mixed with mucous for which pt went to a local hospital and was referred to higher centre.

H/O generalized muscle pains since 4 days

No h/o bone and joint pains

No h/o skin rashes

No h/o cold ,cough,headache,burning micturition,haematuria,loose stools

PAST HISTORY: Not k/c/o DM,HTN,asthma,CKD,CHD

HABITS: He was on mixed diet, appetite normal, constipation only on high protein diet and on alocohol intake,

Occasionally alocoholic (whisky 90ml)

GENERAL EXAMINATION: pt is conscious, coherent, cooperative and oriented to time, place and person

No pallor,Icterus,cyanosis,clubbing, lymphadenopathy,edema


VITALS:

Temperature-99.8°f on presentation 

BP:150/100mmhg

PULSE:79pm

RR:21cpm

Spo2:98% on RA

GRBS:124mg/dl

PER ABDOMEN:

Soft,diffuse tenderness+(more in epigastric and supra pubic region)

Bowel sounds +


CVS:s1 s2 heard, no murmurs

RS: BAE clear, normal vesicular breath sounds heard,no added sounds


CNS: higher mental functions: normal

        Cranial nerves: intact

       Motor system: intact

       Sensory system: intact

INVESTIGATIONS:

DENGUE SEROLOGY:

NS1 POSITIVE

IGM & IGg : NEGATIVE


PT - 14sec
INR - 1.0 
APTT- 30sec















PROVISIONAL DIAGNOSIS:DENGUE FEVER

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