A 23 year old male with fever

 July 20, 2022

 A 23 year old man from Hyderabad Car mechanic by occupation came to the OPD with

C/o Fever for 2 days prior to admission

History of presenting illness

Patient was apparently asymptomatic 5 days back then he developed fever on Friday night that is on 15th of July 2022 which was associated with chills and fatigue.Next day morning he took an antipyretic(dolo 650mg) which was not helpful in subsiding the fever. 

A day later he visited an RMP doctor as the fever did not subside and was treated symptomatically. He was asked to go to a better hospital to get diagnosed and treated as the fever didn't seem to come down. Fever lasted for only two days according to the patient. 

No spikes of fever since admission

H/o fatigue associated with fever

No h/o headache, muscle pains, joint pains,rash.

No h/o cough, abdominal pain, dysuria, diarrhoea, nausea, vomitings

Habitat- Patient informs that his habitat contains a lot of mosquitoes. 

Past history

No similar complaints inthe past

N/k/c/o Diabetes, Hypertension, Asthma, Epilepsy and Tuberculosis. 

Personal history

Appetite- Normal

Diet- Mixed

Sleep-Adequate

Bowel and bladder movements- Regular

Addictions- None

Family history -No similar complaints in the family

Allergy history - No known allergies

General Physical Examination

Patient is conscious, coherent and cooperative

Well oriented to time, place and person. 

No Pallor, Icterus, Clubbing, Cyanosis, Koilonychia, Generalized lymphadenopathy, Edema. 

Vitals

Temperature- 98.6° F

Pulse - 66 bpm

Respiratory rate - 16 cpm

BP - 100/70 mmHg

Systemic examination

Abdomen - Soft, Non tender 

CVS - S1, S2 heard

Respiratory system - BAE present

CNS - No focal neurological deficits

Investigations

Hemogram shows decrease in Platelet count  and highly increased monocytes 


Dengue NS1 antigen appears positive




Liver function tests show elevated SGOT and SGPT


Renal function tests show decreased creatinine, uric acid and slightly elevated Sodium levels


Complete Urine examination shows no abnormal findings


Provisional diagnosis

Viral fever with positive NS1 antigen and with no hemorrhages or petichae 

Treatment

IVF 10 NS/10 RL
Tab. Doxy 100mg po/BD
Tab. Dolo 650mg po/BD
Tab. Pantop 40mg po/BD
Temperature monitoring
Plenty of fluids

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