Vira Pyrexia with Thrombocytopenia

 Unit IV admission

Amc bed 3


DR.HUDA(INTERN)


DR.PAWAN(INTERN)


DR.SHUBHASRI(INTERN)


DR.DURGA(INTERN)


DR.SHASHIKALA (PG-2)


DR. NIKITA(PG-3)


DR. USHA(PG-3)


DR. HAREEN(SR)


DR. ARJUN (AP)


DR. RAKESH BISWAS (HOD)


35 yr old woman presented to the Casuality at 6pm with c/o

Fever since 1 week

Cough since 1 week

Vomiting since morning


 35yrs old unmarried woman born out of a non consanguineous marriage , first in birth order.  Studied till 1 st grade, one day she developed sudden onset of fever at the age of 6 yrs which is followed by vomiting on the next day and finally seizures on the following day, where she developed hemiparesis of left upper limb and lower limb and she was diagnosed with ? polio ( she has not taken any vaccination ), 

Then she was taken to thirupathi hospital for surgery of left hand near the medial side of elbow joint ( ? Elbow stiffness )


She was on oral medication for 2 yrs , over time she regained power in Lt UL and LL .

 She does her own  household chores and takes care of herself and others.


She has been experiencing low grade fever , intermittent , no diurnal variations along with non productive cough since 3 days.

3 episodes of non projectile , non bilious , non blood stained vomiting stained since morning.


Vitals on 17/10/2021

Temp - 98.1 F

PR - 95/min

RR - 20/min

BP - 100/80mmhg

SpO2 - 99% at room air

GRBS - 138 mg%

Lungs - 

Bilateral inspiratory crepts in all Lung fields

Cvs - S1,S2 +

P/A - soft

Non tender

Bowel sounds +

CNS - 

Tone increased in left upper limb and lower limb 

Power 

        Right            Left


UL      5                   4

LL      5                   4


Reflexes 


     Right              Left 

B    2+                   -

T    2+                   - 

S     2+                  -

K    3+                  3+

A     +                    +

P      Flexion bilaterally


Vitals on 18/10/2021

Temp : 100.5F

PR : 80BPM

RR : 16CPM

BP : 110/70mmhg


RS : Decreased Sounds in left IAA and ISA

Rx :

IVF - RL ,NS ,DNS @ 75ml/hr

INJ PAN 40 OD

INJ NEOMOL 100ml ( if temp > 101.1F )

INJ ZOFER 4mg IV/TID

SYRUP AMBROXYL 10ml/PO/TID


Vitals on 19/10/2021

Temp : 101F

PR : 78BPM

RR : 17 CPM

BP : 100/70mmhg


RS : Decreased Breath sounds in left IAA AND ISA

Rx :

IVF - RL ,NS ,DNS @ 75ml/hr

PLENTY OF ORAL FLUIDS

INJ PAN 40 OD

INJ NEOMOL 100ml ( if temp > 101.1F )

INJ ZOFER 4mg IV/TID

SYRUP GRINLLINCTUS 10ml/PO/TID


Vitals on 20/10/2021

Temp : 97.5F

PR : 86BPM

RR : 15CPM

BP : 110/80mmhg


RS : decreased breath sound in left IAA

Rx :

IVF - RL ,NS ,DNS @ 75ml/hr

INJ PAN 40 OD

INJ NEOMOL 100ml ( if temp > 101.1F )

INJ ZOFER 4mg IV/TID

SYRUP ASCORYL 5ml/PO/BD



Provisional Diagnosis

1. Dengue fever with thrombocytopenia

2. With LRTI

3.Known case of ?Polio



                                 Xray on 20/10/2021


Xray on 17/10/2021


                                Left foot


Left hand




Scar on the medial side of elbow




















17/10/2021
Hb : 13.1
TLC : 2600
Platelets: 61000

18/10/2021 (8:00 AM)
Hb : 12.6
TLC : 3700
Platelets : 40000

( 1:00 PM )
Platelets : 20000

SDP TRANSFUSION DONE AT 8:30 PM

19/10/2021
Hb : 12
TLC : 8840
Platelets : 65000


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