32yr old female with generalized weakness and joint pains

A 32yr old male was brought to casualty with c/o fever since 1 week.
Headache since  5 days
Generalized weakness and joint pains.


HOPI : Patient was apparently asymptomatic 1 week back. Then he developed fever which is moderate to high grade, intermittent ( on and off). He visited a local  RMP and took medication. There was mild relief of symptoms.
His outside reports were 
PLT - 1.06 lakhs.

Not a k/c/o DM, HTN, thyroid, asthma, TB, CAD and, CVA.
No h/o any bleeding manifestations (malena, hemoptysis, hematemesis). 
No h/o nausea and vomitings. 
No h/o loose stools, burning micturition, cough. 
No h/o SOB, pedal edema, bowel disturbances. 
Personal history :
Diet g mixed, sleep - adequate, appetite - normal., bowel and micturition - normal. 

General examination : 
Patient is c/c/c moderately built and nourished. 
No  pallor, icterus, cysnosis, clubbing, lymphadenopathy or edema
Vitals:
Temp - 101F
PR-81 bpm
BP - 110/70 mmHg
Spo2 - 99%.
RR - 21 CPM

Systemic Examination :
CVS - S1 S2 +
RS - BAE +, CLEAR,, NVBS. 
P/A - soft, non tender, no organomegaly. 
CNS - NAD

Diagnosis - fever under evaluation ? Dengue. 

Investigations :


29/03/2022
Hemogram 
HB- 13.4, TLC-8300, PLT - 1.42 lakhs
LFT :
DB - 0.58, IB-0.17, SGOT - 66, SGOT - 64, ALT -223,
TP- 5.1, G - 3.2,  A/G - 1.73.
RFT 
Sr urea - 10, Creatinine - 0.9,
 Na/k/CL - 124/3.5/95
Dengue 
NS1, IgM, IgG- negative. 

ECG

2D ECHO


Chest X ray

Diagnosis - VIRAL PYREXIA

TREATMENT 
1.IVF NS, RL, DNS @ 100ml /hr
2.Inj PAN 40 mg po/od
3.Inj zofer 4mg IV bd
4. Inj NEOMOL IV SOS
5. TAB DOLO 650 PO/ QID
6. TAB ULTRACET PO/BD. 

SOAP NOTES 
30/03/2022 :

S - fever spikes +, 2 episodes of vomitings
O - 
Pt - c/c/c
Temp - 102 F
PR- 86bpm
BP -  110/70mmHg
Spo2 - 99%.
RR -18 CPM
Systemic Examination :
CVS - S1 S2 +
RS - BAE +, CLEAR,, NVBS. 
P/A - soft, non tender, no organomegaly. 
CNS - NAD

A-fever under evaluation ? Dengue
Investigations 
Hb - 14.6
TLC - 9,800
PLT - 1.56 lakhs

P:
1.IVF NS, RL, DNS @ 100ml /hr
2.Inj PAN 40 mg po/od
3.Inj zofer 4mg IV bd
4. Inj NEOMOL IV SOS
5. TAB DOLO 650 PO/ QID
6. TAB ULTRACET PO/BD

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