A male patient 62 yr was suffering from watery diarrhea 6 to 7, abdominal pain, anorexia,vommiting and mild fever from 4 days.on examination he had gaseous abdomen,mild cough and mild tenderness over it.Previously taken on counter antibiotics ( not known).Starded tab satrigyl o ,pan 40,ondem 8,ors,sporolac and pcm and Adviced him for CBC,bsl, creatinine, urine routine which reavels leucocytosis 23400 with neutrophilia 90 and lymphopenia 02 , creatinine 4.8,urine shows albumin 1+ and rest f normal.So,Is it infective pathology affecting gut and kidney as in clotridium difficult or malignant renal presentation or covid one??? Or any ??? Plz kindly advise me further management and diagnosis approach.



Suggest RTPCR for COVID Blood test for DDimer, proinflamnatory markers HRCT chest Abdominal ultrasound to check kidney status, and intraabdominal sepsis . ABG ,RFT Admission, IV antibiotics, O2 , iv fluid support, non absorbable gut sterilsers like Rifagut

First kindly do immediately Rapid Antigen Test or Reverse Transcriptase Polymerase Chain Reaction RTPCR to rule out COVID -19.Its looks Neutrophil Lymphocytes ratio increased. ? COVID 19 infecting other organs secondary bacterial infection. 2.Kidney Disease Kindly do 1.HRCT Chest 2 .Chest X ray p a view. Management based on Covid report.

AKD with leucocytosis infective etiology you should have to go for S. Pancreas & USG of whole abdomrn with KFT

Lot of thanks

As WBC 23400 it's not viral. Possibility of covid 19 is not there. Considering pandemic situation & our precaution antigen test + chest x ray can be done. If suspected HRCT - SOS As WBC increased, Its bacterial infection or parasitic affecting gut & secondarily influences kidney ( glomerulopathy). Treating GIT with alternative kidney with resolve symptoms. Need to admit - IV.Metrogyl - BD Inj.Ondem - OD IV.NS - OD IV.Multivitamine - OD Along with that Note urine out ..must be proper. If urine out is less INJ.LASIX SOS As creat 4 - before starting any antibiotics Nephrologist opinion would be preferable. As per provided details- No any such malignancy is present.

Adv USG abdomen and pelvis CBC RBS RFT HIV 1&2 HbSAG CRP Covid-19 RTPCR

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