27 M VIRAL PYREXIA WITH THROMBOCYTOPENIA

 A 27 yr male patient came with complaint of fever since 3 days which is of high grade and continuous type, aggrevated during night and relieved on taking medication and associated with chills since 2 days. 

Patient says he had back ache and joint pains in lower limb associated with fever. 

C/o generalised weakness since 4 days. 

No H/O headache

No h/o vomitings

No c/o cold, cough

No H/O burning micturition 

No h/o hematuria

No H/O diarrhoea, constipation

No H/O abdominal pain & tenderness

No H/O bleeding manifestations and rash

No H/O palpitations,chest pain, syncopal attacks

No H/O loss of apetite, decreased sleep

No H/O loss of consciousness/fatigue/weakness

PAST HISTORY:

Not a K/C/O Diabetes, Hypertension, Asthma, Epilepsy,T.B,CVA,CAD

No past history of similar complaints

No past history of hospitilization or surgery

FAMILY HISTORY:

No H/O Diabetes, Hypertension, Asthma, Epilepsy, Tuberculosis, CVA, CAD. 

PERSONAL HISTORY:

Diet :mixed

Sleep :adequate 

Bowel and bladder :regular

Appetite: normal

Micturition :normal

GENERAL EXAMINATION: 

Patient is conscious coherent and cooperative

No pallor, icterus, cyanosis, clubbing, lymphadenopathy and pedal edema

VITALS:

Temperature:99 F

Pulse:82bpm

Blood pressure:130/90mm of hg

Respiratory rate:22 cpm

SpO2 :98 %at room air

SYSTEMIC EXAMINATION:

CVS EXAMINATION:

s1,s2 heard

No murmurs

RESPIRATORY SYSTEM EXAMINATION :

Bilateral air entry present

Normal vesicular breath sounds heard

No added sounds heard

PER ABDOMEN EXAMINATION:

Scaphoid abdomen

No tenderness

No palpable mass 

Bowel sounds heard. 

Liver and spleen not palpable. 

CNS EXAMINATION:

No abnormality detected. 

INVESTIGATION:

DAY 1:












DAY 2:



DAY 3:




PROVISIONAL DIAGNOSIS:

Viral pyrexia with thrombocytopenia 

Dengue NS1 antigen positive

TREATMENT:

IV FLUIDS : NS - 1, DNS - 1, RL - 1 @ 100 ml/hr

Tab. Doxycycline - 100 mg BD

Tab. Paracetamol - 650 mg SOS

Tab. Pantoprazole - 40 mg OD

Inj. Zofer - 4 mg IV

Input/ output charting, monitoring of vitals and bleeding manifestations was done. 

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