Diagnostic and treatment please... A male aged 25 years came to me today with complaints of high grade fever , joint pain, difficulty in walking, nausea since 5 days and rashes on body and post auricular lymphadenitis since 3 days.

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Dx :- From the symptoms and clinical presentation, most probable diagnosis is Dengue. 2nd possibility is Chikungunya. Advice : - CBC,MP, Platelet count, CRP, DENGUE NS1, IgM and Chikungunya IgM. LFT, RFT. Rx :- 1 ) Rest. Plenty of fluids per oral 2 ) Supportive therapy 3 ) Acetaminophen 500 / 650 mg - If temperature >= 101 degree F or joints pain - 1 tab TDPC X 2 days and then SOS. 4 ) Pantoprazole 40mg + Domperidone 30 mg - 1 cap ODAC 5 ) IV fluid sos. Monitoring of PCV and Platelet. If necessary PT & APTT. D / D : - Viral exanthem due to other viruses like Rubella (usually h/o classical appearance of rashes) , Measles is unlikely though possible.

It is a book picture of chicken gueniya. Fever ,joint pain , swelling in few joints , anorexia , vomiting, rashes on body, cervical lymphadenitis. WBC and Platelet count with in normal limits. Symptoms are relieved with 5 to 7 days, Paracetamol and Domperidone are mostly prescribed. In severe pain HCQS 200mg BID is given. Whole Rajasthan and Delhi every family is suffering from chicken gueniya

So I was little closer on differential sir... thanks for sharing nice case...

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Its viral exanthem.. Dd Measles Rubella (German measles) Chickungunya Dengue

Most likely viral exanthem..should rule out dengue, chikhungunya, malaria..

viral but rule out malaria and typhoid

Viral exanthem

start oral Corticosteroids.then check cbc esr widal mp dengu ns1 and chikungunyaa kft lft

Never Ever give oral steroids in viral fevers or it can cause dissemination of infection... In some cases with viral meningitis or transverse myelitis u can give steroids with antibiotics coverage...

German measles


Viral exanthem

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