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
Left foot
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