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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.

A 20 year old male patient,shop worker by occupation from Kattangur,presented to the opd with chief complaints of fever since 5 days.

History of present illness:

Patient was apparently asymptomatic 5 days back then he developed fever which was intermittent.

No history of cold,cough,nausea,vomiting

No history of hematuria

No history of buring micturition.

No bleeding gums.

No other bleeding manifestations.

History of past illness:

The patient was not a known case of hypertension,diabetes mellitus,bronchial asthma,epilepsy & tuberculosis.No history of any surgeries.

Personal history:

Mixed diet

Bowel & bladder - Normal

No addictions

Family history:

No history of similar complaints in the family members.

General Examination:

The patient is conscious,coherent and cooperative.He is well oriented to time,place and person.

No Pallor

No Icterus

No Cyanosis

No Lymphadenopathy 

No Pedal Edema

Tempature - 99 degrees F

Pulse rate - 98 bpm

Respiration Rate - 18/min

Blood pressure- 110/70

SpO2 98% at room air.

GBRS - 126 mg%

Systemic examination:

CVS : S1 S2 +

RS- Bilateral air entry + 

per abdomen- soft,no tenderness,

CNS- Conscious,Speech normal.

Provisional diagnosis- Dengue NS1 positive with thrombocytopenia.

Investigations :

Complete Urine Examination:

Albumin-trace 

Sugar-nil 

Pus cells-3-4 

Epithelial cells-2-3 

RBS-109 Mg/dl 

Liver Function Test:

T.bil-0.69 

D.bil-0.18 

AST-50 

ALT-19 

ALP-128 

T.Protein-6.0 

Albumin-2.6 

A/G-0.76 

Renal Function Tests 

Serum Creatinine-1.4 mg/dl

Blood urea - 26 mg/dl

Serum electrolytes :

Sodium - 138 mEq/L

Potassium - 3.8mEq/L

Chloride- 98 mEq/L

HCV - Negative

HBsAg- Negative

HIV - Negative

 

ECG -

Treatment 

1)IVF:NS,RL,DNS @100 ml/hr

2) PLENTY OF ORAL FLUIDS

3)INJ.PAN 40MG IV/OD

4)TAB.DOXY 100 MG PO/BD

5)TAB.DOLO 650 MG PO/SOS

6)LOOK FOR BLEEDING MANIFESTATIONS

7)INJ OPTINEURON 1AMP IN 100 ML NS IV/OD

8)GRBS 12TH HORLY

9)LOOK FOR POSTURAL DROP IN BP 

10)INJ.NEOMOL IF TEMP >101 DEGREES F IV/SOS