FITZ HUGH CURTIS SYNDROME

Clinical case Chief Complaints Pt is a 30 yr old house wife living in a slum area, is complaining of severe pain in lower abdomen high grade continous fever burning micturition and purulent vaginal discharge for 2 days She was given oral antibiotic and pain killer ( indomethacin) as suppository After 3 days she is hospitalized because of severe pain in right Hypochondrium which radiates to the right shoulder associated with vomiting and dry cough Vitals BP 90/60 Pulse 120 Temp 38.9C Physical Examination Inspection Looks ill dehydrated Palpation Liver enlarged Tender Hepatic rub present Percussion Stony dull in right lower chest Auscultation Right lower chest absent breath sound Investigations Suggest Diagnosis Differential diagnosis?

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D/Dx Ruptured ectopic pregnancy. Hepatic abscess with Empyema thoracis. Disseminated gonococcal infection. Pyelonephritis. Appendicitis/perforated appendix Cholecystitis/perforated gall bladder.

? UTI .. ? GENITO-URINARY TRACT INFECTION.. ? PID.. NEED'S.. HEMOGRAM.. URINE ROUTINE.. VAGINAL SWAB C&S EXAMINATION.. USG..ABDOMEN..PELVIC .. GYNECOLOGICAL EXAMINATION WITH EXPERTS OPINION..

Tnx Dr Anil Gangani
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YES POSSIBLY ...HEPATIC AND GALL. BLADDER. PATHOLOGY NEEDS FURTHER. EVALUATION

Acute cholecystitis Liver Abscess

UTI c PID/ Appendicular pain USG, Haemogram,Urine examination. Inj Tramadol,Inj Ondasteron,Inj Ceftriaxone. Tab cystone,syp Neeri, syp Alkasip,PID kit,Tab Azithral ,tab Rabezol-DM helpful..

Need Other test, USG abdmine, for burning Micturition, Rx Punarnavashtak qwath BD Galo ghan tab 1bd

Urinary tract infections (UTIs)

P I D Inj Oflox iv drip Inj Metrogyl iv drip