A 35 year old female with fever
September 06 ,2022
A 35 year old female farmer by occupation resident of miryalaguda came to hospital on 2/9/22 with
C/O fever , burning micturition , lower abdominal pain , lower back pain since 6 days and dry cough and sore throat since 5 days.
HISTORY OF PRESENT ILLNESS
The patient was apparently assympomatic 6 months back.She developed joint bilateral pains after which she was treated at private hospital at miryalaguda and now she came with complaints of fever which was peak in the evening with chills and rigor and burning micturition associated with lower abdominal pain and lower back pain . She had dry cough and sore throat .
HISTORY OF PAST ILLNESS
She had undergone 3 caesareans
No history diabetes mellitus No hypertension
No asthma
No CAD
No epilepsy
No bleeding manifestations
No malignancy
No rash
TREATMENT HISTORY
No DM ,HTN,CAD,Asthma,TB, antibiotics, surgeries,blood transfusions, chemoradiations.
PERSONAL HISTORY
Married
Farmer by occupation
Normal appetite
Mixed diet
Burning micturition
No known allergies
No alcohol , tobacco, drug ,beetel leaf addiction
FAMILY HISTORY
No DM ,HTN,CAD,Stroke,cancer , asthma
PHYSICAL EXAMINATION
GENERAL EXAMINATION
Pallor -Yes
Icterus- no
No cyanosis , clubbing of fingers ,lymphadenopathy, oedema, malnutrition, dehydration
Vitals---
Temperature - 97.6F
Pulse- 78bpm
Respiratory rate- 20 beats/min
BP- 100/50 mm Hg
SpO2- 96%
GRBS-102mg%
SYSTEMIC EXAMINATION
CVS
No thrills
Cardiac sounds S1 S2+
Cardiac murmurs - no
No dyspnea
No wheezing
Position of trachea-central
Breath sounds -vesicular
ABDOMEN
Shape of abdomen- scaphoid
Tenderness - yes
Palpable mass - no
Hernial orifice - normal
Free fluid -no
Liver and spleen not palpable
Bowel sounds - no
CNS
Conscious
Speech normal
INVESTIGATIONS
TREATMENT
Dolo tablet
Citrizen tablet
Neomol injection
Inj- optineuron
Citralka syrup
Pan 40 tablet
PROVISIONAL DIAGNOSIS
Viral pyrexia
