GM CASE 8

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 A 60 year old Male who is a labour by occupation visited our opd which chief complaints of fever and cough since 15 days .

History of present illness:

  Patient was apparently asymptomatic 3 years  back then  he developed fever associated with chills which is intermittent and also dry cough .He joined our hospital it got reduced and he discharged.before 15 days he again developed  high grade fever associated with 

Loose stools,low backache, burning micturation,sob. 

No h/o abdominal pain, no h/o heamaturia.

So he visited local hospital but there is no use then he immediately joined our hospital. 

Past history:

  Patient suffered from similar complaints in the past.

No h/o diabetes 

No h/o hypertension 

 No h/o epilepsy

No h/o TB

No h/o asthma 

No history of any previous surgery in the past. 

Personal  history:

Appetite:decrease

Diet:mixed 

Adequate:sleep 

Bowel  :loose stools 

Bladder:normal 

 Occasionally alcohol and  cigarette but stopped before 3years.

Family history:

No similar complaints in the family. 

Drug history:

No allergy to known drugs.

General examination:

 Patient is conscious,coherent, cooperative. 

No pallor 

No cyanosis 

No lymphadenopathy 

No clubbing 

No icterus 

No edema

No tremors 

Temp: 101°f

Pulse rate:104/min

RR:29/min

 Bp:110/80








 


Systemic examination:- 

 Cvs:

S1 and s2 are heard .

 Respiratory system 

No dysponea 

Position of trachea central .

Abdomen:

No tenderness 

No palpable mass

Bowel sounds are present. 

CNS

   Patient is conscious 

Speech is normal 


Provisional diagnosis:

 Viral pyrexia,urinary tract infection.


Investigations:




ECG








Treatment:

Inj pantop 40mg IV

Inj neomal 1gm iv

Tab dolo 650mg 

Plenty of oral fluids 

Syrup grllinctus 10mg po/bd







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