A 21 YEAR OLD FEMALE WITH DENGUE AND THROMBOCYTOPENIA

 A 21 yr old female resident of Ismailpalli who is a student by occupation came to casuality with chief complaints of 

*  Fever since 5 days 

*  Body pains, Vomitings since 5 days

*History of Cough since 5 days which is non productive


• History of Presenting Illness

 *A 21 yr old female had fever which is insidious in onset,high grade,continuos ,which is associated with chills and rigors and body pains since 5 days 

*History of Vomitings 6 episodes per day, which is non bilious,non projectile ,which consists of food particles and water as content which is associated with abdominal pain since 5 days.

*History of headache in frontal region 

*There is no history of cold, burning micturition, ear ache, tinnitus shortness of breath,chest pain, palpitations, diarrhoea,eye pain.

*There is history of intake of junk food 2 days before onset of symptoms 


•Daily routine:-

• Normally wakes up at 7am in the morning and do her regular activities and goes to the college and attend her clinicals (B.sc nursing) and eats lunch in between 1-2 pm and she will comeback to hostel by 4pm in the evening and she will have snacks on roadside frequently and she will sleep at 10pm.

•PAST HISTORY :- 


NO H/O DM, HTN, asthma, epilepsy


No previous surgical history 

*HISTORY OF RASH SINCE 7 TH CLASS .

•PERSONAL HISTORY 


Diet : mixed 

Appetite : decreased since 5 days 

Sleep : inadequate 

Bowel & bladder : regular 

No Addictions

•ALLERGIES :she is allergic to potato, brinjal 

•FAMILY HISTORY : No significant family history 

• MENSTRUAL HISTORY : 

*Age of Menarche: 12

*No. of days Bleeding:5 days 

*LMP : 25/ 06 /22 

*DYSMENORREHEA PRESENT 

 *No Gynecological problems

 •GENERAL EXAMINATION : 

Patient is conscious, coherent, cooperative.

Well built and well nourished. 

Pallor , Icterus,clubbing, cyanosis, koilonychia, edema are absent




* No pallor 



*No clubbing



*No edema 




•VITALS 


Temp- Afebrile (100 f) 


Bp-100/80 mm hg


PR- 84bpm


RR-16CPM


Spo2- 99% on RA


GRBS : 102


•SYSTEMIC EXAMINATION : 


RS- bilateral air entry present 


CVS : S1, S2 + no murmurs 


P/A- soft and non tender

bowel sounds present 


 CNS : No focal neurological defeicit 

All reflexes are normal .

•INVESTIGATIONS

*HEMOGRAM: 



*RFT 



*LFT 



*COMPLETE URINE EXAMINATION :


*APTT


*BLEEDING AND CLOTTING TIME


*MALARIAL PARASITE 


*BLOOD FOR M.P.-STRIP TEST


*PROTHROMBIN TIME 



*BLOOD GROUPING AND Rh TYPING 




*Fever chart showing continuous type of fever.





*RASH 




*Petechiae over the palate 


• Platelet count 









*Record of Temparature,BP, RR AND SPO2



ECG:





USG: NORMAL 



*CHEST X RAY PA VIEW :

      





*PROVISIONAL DIAGNOSIS : 

• DENGUE WITH THROMBOCYTOPENIA 


*TREATMENT :


✓IVF ( NORMAL SALINE , RINGER LACTATE )

75 ml / hr 

✓ Inj Xone 1gm IV /BD

✓Inj Mifenac  MR PO / BD

✓Tablet okacet PO/BD 

✓Tablet Doxy 100mg/PO/BD 

✓ plenty of fluids ( oral )

✓Tablet metaspas PO / BD

✓Inj Neomol IV /SOS

✓ Tablet PCM 600 mg PO / TID 


25/7/22-27/7/22




*There is history of blood transfusion on 26/7/22 

*Transfusion was uneventful no reactions were present .







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