20yrs old male pt working in hair saloon came wid c/o Cough wid Expectoration since 2 weeks....Headache , Chest pain, Fever , Nasal block, Breathlessness since 2 days .......Diagnosis & Management??

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Diagnosis: Acute Exacerbation of CH.Asthmatic Bronchitis Management: Hospitalization . Detailed history & Physical Exam. 1.Propped up position 2.O2 inhalation 3.I/V line 5%Dextrose slow 4.Inj.Derriphyline 1 amp I/V slow stat & 8 hourly 5.Inj. Ceftrioxone 1 GM. I/V slow BD 5.Assess clinically for Respiratory rate & auscultate chest, if rhonchi are still present, add 6. Inj. Hydrocortisone 100 mg I/V stat & 8 hourly 7 Temp. Record 4hourly . If temp. > 102 degree F , Tab. Calpol 1 tab. sos strength depends on wt. 8.Otrivin nasal drops 1-2 drops each nostril 6to 8 hourly 9.Watch vitals 10.Further tests:from the provided History& tests,the Sinusitis is a risk factor for asthmatic Bronchitis.Cxr PA View has features S/O obstructive Airway Disease which with H/o cough with expectoration,is indicative of asthmatic bronchitis which could be allergic because of Eiosinophilia.Send: a) Sputum for eiosinophils(if eiosinophils are present, such patients respond to low dose of 30 mg. Prednisone which may be tapered to lowest dose controlling SIG's & Symptoms), AFB. b) IgG level C)PFTs d)XRa y PMS & ENT consultation E)ECG 11.Bronchidilator cough expectorant. 12.Once patient is stabilized , shift to oral medications.Treatment to be reviewed after results of investigations are received.

do sputum examination for AFB, Xray PNS and CXR.pt seems to be a case of NBA with secondary infection.Treat with Antibiotics,bronchodilators. steam inhalation, and mast cells stabiliser along with mucolytic.Investigate for Koch,s and sinusitis.

Allergic Bronchitis Tab Cepodoxime 200 mg BD for 12 days Tab Paracetamol SOS Tab Montelakast OD HS. Tab Multivitamins OD All for one week Syrp Cadiphyllate 2tsf TID. Albendezole + Ivermectin combinations single dose Hot water fomentation with tincture benzene

SPTUM = C,& S SPTUM AFB CXR BLOOD CBC BACTEC BLOOD CULTURE O2 SATURATION RX PARACITAMOL O2 lnhalaton Steam inhalation If bronchospasm salbutamol inhalation Antibiotics from c,& a report

most likely ,its allergic bronchitis. as they are using chemicals at Barbara shop.u can get absolute eosinophillic count,CBC,chest xray. one week course of antibiotic with supportive treatment for allergy with monteleucast and fexofendine and antipyretics should be helpful.and AEC ,is raised then he may require anti allergic for a longer duration kindly mention chest auscultation findings too

20 YEARS OLD PT WORKING IN HAUR SALOON WITH FEATURES OF .ARDS FIRST DO COVID 19 TEST AND THEN MONITER THE VITAL SIGNS OXYGEN SATURATION RESPIRATION PULSE BP BLOOD GASES

best advise is to change occupation allergens from hair dye or fine particular of hair which r breathed in rest tt is advised properly

allergic bronchitis with secondary bacterial infection, amoxyclav, antihistaminics with hetrazan, bronchodilators, low dose steroids with antipyretics should be used

Occupational hazard, can label it as pneumoconiosis

Sputum exsmination reports Gram stain - few pus cells & few epithelial cells/hpf Gram positive cocci in chains, Gram negative bacilli & Gram positive bacilli seen. Culture yields the growth of normal oropharyngeal flora....wts nxt step nw??

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