Concluded Case

FLU LIKE SYMPTOMS

46yrs/F complained of Fever,cough and myalgia from 4days,No respiratory symptoms.The patient had diabetes mellitus from 4years, with the diabetes being treated by an endocrinologist, and was otherwise healthy and had an active lifestyle. Vitals Bp - 140/90,HR - 110,Spo2 -98% on room air,RR -18/my,Temp -101 Investigations D dimer - 639,CRP -70,LDH -600,HbA1c -9,RBS -450 RT PCR FOR SARS-COV 2 NEGATIVE

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Concluded answer

Peripheral ground glass opacities typical of Covid 19 It need to be considered as Covid 19 case and treated at per protocol High D dimer - use low molecular weight heparin twice daily High CRP indicates moderately severe disease You can use following regimen Capsule Doxy 100 mg one capsule twice a day for 7 days Tablet Azee 500 mg One tablet daily for 7 days Tablet Ecosprin 75 mg one tablet daily for 30 days Tablet Ivermectin 12 mg One tablet daily for 4 days Tablet Favipiravir 200 mg Day 1 - 9 tablets in morning and 9 tablets in evening Day 2 to Day 7 4 tablets in morning and 4 tablets in evening Glargine insulin along with short acting insulin for control of blood sugar Please find my article on role of insulin in treatment of Covid 19 Insulin has very important role in treatment of Covid 19 https://jmscr.igmpublication.org/home/index.php/archive/178-volume-08-issue-07-july-2020/9517-use-of-insulin-in-treatment-of-covid-19-a-proposal-to-explore-feasibility

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Cxray shows mediastinal widening and para cardiac heziness on left side. CT thorax showing bil subpleural ground glass opacities with septal thickening. Findings sugg of atypical viral pneumonia. Adv repeat RT PCR. medical management including antiviral treatment.

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CXR..STUDY.. GGO.. ? ILD..PNEUMONITIS.. WITH.. DM.. HIGH DIMER.. ELEVATED CRP LEVELS.. RT..PCR..COVID-19..NEGATIVE.. NEED'S.. MANAGEMENT AS PER PROTOCOLS.. FOR..COVID-19..

Tnx Dr Ramesh Kumar Singh
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Peripheral ground glass opacities typical of Covid 19 It need to be considered as Covid 19 case and treated at per protocol High D dimer - use low molecular weight heparin twice daily High CRP indicates moderately severe disease You can use following regimen Capsule Doxy 100 mg one capsule twice a day for 7 days Tablet Azee 500 mg One tablet daily for 7 days Tablet Ecosprin 75 mg one tablet daily for 30 days Tablet Ivermectin 12 mg One tablet daily for 4 days Tablet Favipiravir 200 mg Day 1 - 9 tablets in morning and 9 tablets in evening Day 2 to Day 7 4 tablets in morning and 4 tablets in evening Glargine insulin along with short acting insulin for control of blood sugar Please find my article on role of insulin in treatment of Covid 19 Insulin has very important role in treatment of Covid 19 https://jmscr.igmpublication.org/home/index.php/archive/178-volume-08-issue-07-july-2020/9517-use-of-insulin-in-treatment-of-covid-19-a-proposal-to-explore-feasibility

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Bilateral hazinnes with Ground glass opacities present, highly suspicious of Covid 19. Other viral markers also raised Treat as per covid Start Glargine for diabetes

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Most likely biomarker DTimer crp serum LDH all are high even Rtpcr negative even then HRCT thorax shows nodular mottling and ground glass appearance of bilateral lung parenchma.hyperglycimia is also a feature of covid19. Case must be treated in critical care as per protocol of covid 19.

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Areas of atelectasis and heterogenous consolidstion ( halo sign) in bilateral lung parenchyma. Bilateral major fissural thickening.Not classical covid pattern.. possibilty of cryptogenic organising pneumonia.

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B/L GGO with haziness, it's goes to SARSCOV2,/ pneumonitis with DM/ Do H1N1,

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Lt cardiac region pneumonitis with DM uncontrolled All parameters of blood in favor of sarscov2 Repeat after4 days RT PCR Viral pneumonitis

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multiple lymphadenopathy and fever Mantoux test should be done in this case, meanwhile give him rasayan chikitsa with dipan,pachan

Bilateral ground glass appearance ask for RT-PCR to ruled out COBID-19

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