43 female presented with dyspnea dry cough fever since 4th oct.spo2 94 %with nasal o2. lab,hrct,cxrays attached.patient is receiving antibiotics bronchodilators and antivirals.patient is slowly progressing.any suggestions in management plz.

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Xray chest suggests lt basal pneumonitis 2nd xray shows well developed pneumonia lab reports support viral in nature and successive report shows good improvement so over all good work and good response too if pt still coughing haressingly than nebulisation or rotacaps.

Agree with Dr Agarwal.
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Viral pneumonitis left basal consolidation Pancytopenia To rule out dengue h1N1 If dengue positive do usg abdomen and chest for pleural effusion and ascites Broad spectrum antibiotics and antivirals iv fluids analgesics cough suppressant and nebulized bronchodilators Non invasive ventilation if required

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11 Oct CBC pancytopenia with anaemia & 9 Oct x ray lt side pleural effusion To r /o dengue Adv Dengue IgG IgM, usg abdomen,

Thanks sir,Dengue IgG positive,IgM,NS1 negative.
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Viral Pneumonitis /consolidation, pancytopenia, clinical improvement with antiviral, antibiotics and bronchodilators. Most likely dengue. Dengue NS-1, IgG and IgM.

A patch of pneumonitis at left base. ?sputum culture.

Thanks sir!
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Viral pneumonia in v/ o leukopenia and CT findings. Consider H1N1 also.

Radiological findings.. Bilateral peri Hilar pneumonitis & posterior basal Segmental collapse / consolidation. Round & patchy consolidation a lso apparent in Rt apex Kindly ascertain any minimal pl effusion if any - - USG can pick it up. Do repeat CT CHEST contrast enhanced to look in for mediastinal adenopaty... after your course of management. CXR are usually deceptive in imaging posterior segments Marginal drop in platelet count is a concern. I my opinion it's more of infective etiology.

Thanks a lot sir!
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If Dengue positive, it could be Diffuse patchy Segmental consolidation, us usually there will be pl. Eff & ascites, kindly perform USG Abdomen as well.

Lt.pleural effusion.dengue can cause pancytopenia & decrease platelet

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