A 22 year old male with yellowish discoloration of sclera

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A 22 year male auto driver by occupation came to opd on 16th june with chief complaints of


•Fever since 15 days

•Vomiting since 12 days

•Yellowish discoloration of eyes since 12 days.



History of presenting illness:-



Patient was apparently asymptomatic 15 days back then he developed fever which is continuous , no chills and rigors.

For this he visited local RMP and took medications by which fever got subsided, but the yellowish discolouration of skin and sclera remains. 

3 days later he developed vomitings, 6 to 7 times a day, non bilious, non projectile, food particles as contents, non blood tinged.

Then patient went to a hospital where he was diagnosed with dengue fever.

He also gave a history of intake of food from an unusual setting for 4 days after which the symptoms worsened. 


Past history:

N/k/c/o DM, HTN, CVD, Asthama, Epilepsy, Thyroid problems

No history of similar complaints

No history of any blood transfusions

No history of any previous surgeries


Personal history:


Mixed diet

Adequate sleep

Normal bowel and bladder movements

No addictions (Toddy occasionally)

No allergies


Family history: 

Not significant


General examination

Patient is conscious, coherent and cooperative, well oriented to time, place and person






Vitals:

Pulse: 72

Bp: 120/80

Temperature: afebrile

RR: 17


Systemic examination:


CVS- S1 S2 heard no murmurs

CNS- No focal neurological deficit

RS- Normal vesicular sounds heard



Provisional diagnosis:


Fever with thrombocytopenia Dengue? Acute viral hepatitis due to Hepatitis A virus?. 

Investigations






Treatment 


15 /6/23


Rx


1).IV fluids Ns 75ml /hr

2)Inj zofer 4mg iv/tid

3)tab udiliv 300 mg 

4)inj optineuron 10 mp 1 ONS/iv

5)syp hepamerz 10 mL iv 

6)tab dolo 650 mg sos



16/6/23


Rx

1)IV fluids Ns 75ml /hr

2)Inj zofer 4mg iv/tid

3)tab udiliv 300 mg 

4)inj optineuron 10 mp 1 ONS/iv

5)syp hepamerz 10 mL iv 

6)tab dolo 650 mg sos




17/6/23

Rx

1)IV fluids Ns 75ml /hr

2)Inj zofer 4mg iv/tid

3)tab odiliv 300 mg 

4)inj optineuron 10 mp 1 ONS/iv

5)inj doxy 100mg po/BD

6) tab dolo 650 mg sos

7) syp hepamerz 10 mL iv 

8)Syp lactulose 15 mL bd 


18/6/23

Rx

1)IV fluids Ns 75ml /hr

2)Inj zofer 4mg iv/tid

3)tab odiliv 300 mg 

4)inj optineuron 10 mp 1 ONS/iv

5)inj doxy 100mg po/BD

6) tab dolo 650 mg sos

7)syp hepamerz 10 mL iv 

8) Syp lactulose 15 mL bd 




19/6/23

Rx

1)IV fluids Ns 75ml /hr

2)Inj zofer 4mg iv/tid

3)tab odiliv 300 mg 

4)inj optineuron 10 mp 1 ONS/iv

5)inj doxy 100mg po/BD

6)tab dolo 650 mg sos

7) syp hepamerz 10 mL iv 

8)Syp lactulose 15 mL bd

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