45 year old women with viral pyrexia with thrombocytopenia

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Case-

A 45 year old female came to casuality with
 C/O FEVER since 3 days 
 C/O vomiting since 3 days
Hopi:
Pt was apparently asymptomatic 3 days back then she developed fever associated with chills and rigors, subsided with medication, complaints of vomotings since 3 days which has food particles as content 
No c/o chest pain,burning micturition,loose stools, pain abdomen 
No c/o nausea,cough

Past history-
No similar complaints in the past
she is a not a k/c/o DM/HTN/ASTHMA/EPILEPSY/TB
She is a non alcoholic and non smoker

O/E: 
Pt is conscious , oriented to time , place , person
 
No pallor , Icterus, cyanosis , clubbing, lymphadenopathy , edema. 

Vitals: 
BP - 110/80mm of hg
PR - 94 bpm 
Spo2 - 98%at RA 
RR- 22cpm
GRBS - 119 mg/dl 

Systemic examination: 

Cvs: s1 s2 present , no murmurs

Rs: BAE present, normal vesicular breath sounds present. 

P/A: soft, non tender , bowel sounds present 

cns-intact 

Provisional diagnosis:VIRAL PYREXIA WITH THROMBOCYTOPENIA

Investigations
On 05-09-2021
Hemogram: 
HB:15.8 
RBC:5.23 
WBC:10300 
N-31
L-57
M-10
E-02
B-00
PLT- 50000 

CUE: 
Albumin- nil
Sugars-  nil
Pus cells - 2 to 3
Epithelial cells - 2 to  3

RFT:
Serum creatinine - 0.8mg/dl 
Na+ - 134 meq/lit
K+  - 3.5 meq/lit
Cl-  : 104meq/lit
LFT:
TB- 1.50 mg/dl 
DB - 0.75 mg/dl 
ALP- 354 meq/lit
SGOT- 73 IU/LIT
SGPT- 72 IU/LIT

0n 07-09-2021
Hemogram-
HB-13.8
TLC-22100
N-10
L-81
MCHC- 35.1
RBC-4.58
PLT-55000
  
X ray-
USG-


Rx:
On day 0:-
1) IV fluids - NS &RL
2) Tab.Dolo 650 mg/PO/TID
3) Inj.Zofer 4mg IV/OD
4) Inj.Pan 40 mg IV/OD
5) Inj.Optineuron  1amp in 500ml NS IV/OD
6) Tab.Cetrizine 5mg PO/BD
 
On day 1:-
1) IV fluids - NS &RL
2) Tab.Dolo 650 mg/PO/TID
3) Inj.Zofer 4mg IV/OD
4) Inj.Pan 40 mg IV/OD
5) Inj.Optineuron  1amp in 500ml NS IV/OD
6) Tab.Cetrizine 5mg PO/BD

On day 2:-
1) IV fluids - NS &RL
2) Tab.Dolo 650 mg/PO/TID
3) Inj.Zofer 4mg IV/OD
4) Inj.Pan 40 mg IV/OD
5) Inj.Optineuron  1amp in 500ml NS IV/OD
6) Tab.Cetrizine 5mg PO/BD
 
 





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