A 35yr female pt c/o-fever with chills 4-5days bodyache, headache, weakness, burning micturation Pathology reports attached below plzz suggest needful

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Fever of short duration with leukopenia might be due to any viral illness like common cold, influenza or even the dengue. In first week fever of enteric fever leukopenia is unlikely however may seen in prolonged fever. Positive symptoms for viral prodromes like bodyache, headache, high fever etc fervour viral illness. Advice Blood for Dengue NS1 & IgM, Typhi dot. Repeat Hematocrit (PCV) & Platelets. Urine analysis shows clear appearance and normal colour with acidic reaction don't favour bacterial infections. But little raised pus cells in there and epithelial cells. She might have sterile pyuria or urine is contaminated. Better to repeat test in fresh sample. Albumin 3+ is matter of concern. Ask for pre exiting Diabetes or Hypertension, Oliguria, Streptococcal sore throat 3-4 weeks earlier, Anasarca or ankle sweeling or facial puffiness, Costovertibral junctional (renal point) tenderness etc. Send Urine repeat test. If found same result then send early morning spot sample of urine for Albumin Creatine ratio or 24 hr urinary protein. Blood for Creatinine and BUN. Imaging like contrast CT to r/o pyelonephritis is needed only if these reports found normal and emperical Ceftriaxone /fluroquinolones fails. However acute pyelonephritis is less likely as no neutrophilia in there. Little decrease in Hb and Platelets are common in UTI /Pyelonephritis /Any viral illness. So my PD is Viral infection (might be dengue or other) with Sterile pyuria with contaminated urine sample. Send fresh urine sample for analysis, Advice adequate water intake, symptoms treatment, Ceftriaxone to cover enteric fever and pyelonephritis if any (though less likely). Send blood for Dengue NS1,IgM, Typhi Dot, Platelates, Haematocrit, Creatinine. May send Urine culture if repeat sample shows same findings.

Dengue fever with UTI Needs further investigations and evaluation to conclude diagnosis and treatment plan. First treat dengue with PCM and plenty of liquid. Green leafy vegetables and fruit and fruit juice.

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HYPERPYREXIA..WITH.. LEUKOPENIA..& THROMBOCYTOPENIA.. WITH..UTI.. NEEDS FURTHER CLINICOPATHOLOGICAL EVALUATION.. HEMOGRAM.. MP WIDAL .. DENGUE TEST.. KFT.. USG STUDY ABDOMEN.. MEANWHILE TREAT AS HYPERPYREXIA WITH UTI.. RX.. APPROPRIATE ANTIBIOTICS..LEVOFLOXCIN. ANTIPYRETIC..PCM URINE ALKALIZER..SOS.... SYMPTOMATICT TREATMENT.. IV FLUIDS SOS.. PROCÈED AS PER REPORTS WITH EXPERTS OPINION..

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Dengue fever with UTI Pancytopenia Adv DENGUE IgG IgM, MP, WIDAL test, USG full abdomen CBC Monitor vital Dialy CBC Complete bed rest Intake Plenty of more water orally Inj vit k x 3 day Inj monocef 1gm BD Inj pan 40mg BD Inj pcm tds Inj emset sos Inj multivitamins Ivf NS DNS Tab plarica /platimax tds x 15 days Soft liquid diet Coconut water juicses papaya juice kiwi Maintain hygiene Improve general body health

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Maintain hydration level and vitals inj acetaminophen sos , 3rd gen Cefelosporine, CBC daily , watch out put level sos CT KUB

UTI, Dengue

Dengue fever with Uti. Rt with paracetamol and plenty of fluids. Further investigations. To be done and plan rx

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