VIRAL PNEUMONIA WITH THROMBOCYTOPENIA, HEPATITIS

C/o FEVER SINCE 10 DAYS 

GENERALIZED BODYPAINS SINCE 10 DAYS

PAIN ABDOMEN SINCE 5 DAYS 

SOB SINCE 5 DAYS

HOPI: 

PATIENT WAS APPARENTLY NORMAL 10 DAYS BACK THEN SHE DEVELOPED FEVER, LOWGRADE A/W CHILLS AND RIGORS NOT A/W COUGH,NO BURNING MICTURITION,NO VOMITINGS, NO LOOSE STOOLS, 

FEVER SUBSIDED  AFTER MEDICATION 5 DAYS BACK.  THEN SINCE 5 DAYS PATIENT DEVELOPED PAIN ABDOMEN AROUND UMBILICUS AND EPIGASTRIUM, NON RADIATING A/W SOB GRADE 3 AND 4. NOT A/W NAUSEA, VOMITINGS, LOSS OF APPETITE.

N/K/C/O HTN,DM,CAD,ASTHMA

VITALS: AFEBRILE.   PR-130.   RR-26.    BP 90/60.   SPO2 90%.    GRBS- 74

GENERAL SURGERY: CECT ABDOMEN TO REVIEW PATHOLOGY.

SEPSIS SECONDARY TO VIRAL PNEUMONIA (RESOLVED) WITH VIRAL HEPATITIS (RESOLVING) WITH THROMBOCYTOPENIA (RESOLVED)

INVESTIGATIONS: 

USG ABDOMEN- NO E/O ANY DILATED BOWEL LOOPS

-VISUALIZED BOWEL LOOPS SHOWS SLUGGISH PERISTALISIS

SUGGESTED CO-RELATION WITH X RAY ERECT ABDOMEN

-MILD HEPATOSPLENOMEGALY.

USG CHEST- 

MILD PLEURAL EFFUSION WITH CONSOLIDATORY CHANGES IN LUNG FIELDS.

TREATMENT :

(1) PLENTY OF ORAL FLUIDS

(2) TAB.PAN 40 MG /IV/OD 

(3) INJ.ZOFER 4 MG /IV/SOS

(4) INJ.OPTINEURON 1 AMP IN 100 ML /NS/OD

(5) INJ.HYDROCORT 100 MG /IV/BD

(6)TAB. PCM 650 MG/PO/SOS

(7) TAB.UDILIV 300 MG PO/BD

(8) TAB.MONTEK-1C 1 TAB/PO/OD

(9) SYP.ASCORYL -D  10ML /PO/HS

(10) SYP.LACTULOSE 10ML /PO/HS

(11) NEB.IPRAVENT -8TH HOURLY

(12) NEV.BUDECORT -12 TH HOURLY

(13) BIPAP 4TH HOURLY

(14) BP/PR/TEMP CHARTING 4TH HOURLY.

(1)TAB.PCM 650 MG/PO SOS

(2)TAB. PAN 40 MG/PO/OD FOR 5 DAYS

(3)TAB.MONTEK-1C 1 TAB/PO/OD for 5 days

 (4)TAB.VERTIN 16 MG/PO/TID FOR 5 DAYS

(5)TAB.UDILIV 300 MG PO/BD for 5 days

(6)SYP.ZINCOVIT 10 ML PO/TID FOR 5 DAYS

(7)HOME NEBULIZATION SOS(IPRAVENT/BUDECORT)

(8)PLENTY OF ORAL FLUIDS

(9)PROTEIN X POWDER 

REVIEW  AFTER 5 DAYS