Concluded Case

Dengue Hemorrhagic Fever

An 80 years old male, with known history of Heart Failure with low ejection fraction of 47%, and Diabetes mellitus since 5 years on Insulin Mixtard and oral hypoglycemics presented with 5 day history of fever with chills. He was treated at home with IV fluids, injectable anti pyretics. He complained of difficulty in degluttition, and was started on Levoflox 500mg infusion, later Augmentin duo 625mg was added. He didn't respond to the medications and fever is recurring. His blood sugar levels are maintained between 70 to 120mg/dl hence insulin and oral hypoglycemics were discontinued. Owing to a small township, blood investigations were limited. What would be the further management of this patient ?

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Concluded answer

Pl get his CBC dengue NS1.Rapid malaria test.urine routine any uti. U can empirical.iv.falcigo 120mg stat and repeat after 12hrs & 24hrs.same dose hope u will get response. Pl add tab doxy 100mg bid

All Answers

Continue fever and diabetic see for blood report See for malaria antigen See for dengue profile After seeing then See for ecg and 2decho to rule out cardiac condition See for urine report to rule out pus cell or urospesis or Ketoacidosis N treat accordingly

Pl get his CBC dengue NS1.Rapid malaria test.urine routine any uti. U can empirical.iv.falcigo 120mg stat and repeat after 12hrs & 24hrs.same dose hope u will get response. Pl add tab doxy 100mg bid

Diabetic pt with low ejection fraction is in heart failure presenting with fever Adv to check ecg look for subendocardial infection Adv xray chest to r/o any covid19 infection

Pl adv CBC, ESR, dengue Ns1 antigen, widal,typhi Dot IGM,urine routine,p/s for mp. Rtpcr for covd 19.cxr pa view. Chances are more of UTI.

Oesophagitis drug related Pantin iv bd sucrafil 10 ml bd Sos barium oesophagus or scopy

Like case of chf, but do all blood test

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