Fever since 4 days

Male patient of age 82 Comes in opd with complain of weakness and fever since 4 days Chief Complaints Fever Headache Weakness History No history of DM ,HTN or any other chronic illness Vitals Bp: 120/70 Pulse; 100 Temprature: 100.1 Spo2 96 Physical Examination Weak Anemic Investigations Cbc: Hb:11.2 Esr: 60 Platelets: 40 thousand Lymphocytes: 12 Widal negetive Diagnosis Covid?? Dengue?? Management Need to be discuss

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PYREXIA..WITH.. THROMBOCYTOPENIA.. ? VIRAL FEVER.. ? DENGUE FEVER.. NEED'S.. MP WIDAL.. DENGUE TEST.. CRP .. RT..PCR..COVID-19..

Thank you doctor.
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WBC count , if it is leukopenia will favour Dengue. If it is leucocytosis with poly predominance, it will favour , COVID . But now we are seeing both in the same patient at the same time. Even inflammatory parameters like CRP, Ferritin, LDH and DDimer are increased in both. CT chest and RTPCR have to decide ..

Thank you doctor.
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This is most likely a c/o covid19 infection Esr is high Lymphocytes are towards lower side So far thrombocytopenia is concerned we find it in all viral fevers but here it is significant as likely infection attacking coagulation system Adv xray chest ecg Sr ferritin D-dimer Hospitalise for treatment

Thanx dr Kute Ankush
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Emerging cases of Co infection ( Covid plus dengue ) Look for bleeding signs , petechaie , look for signs of 3 rd space fluid loss , postural hyoptension , serositis on USG Consider doing ferritin , D dimer ,PCR Covid , If with high D dimer titres like in Covid use of LMWH sill be tricky Needs further monitoring of cougulsrion parameters

I am agree with @Dr. Kute Ankush Sir and @Dr. Krishnan Pichumani Sir.

Thank you, Dr Pranab Bera
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Possibility of covid 19 with dengue

Thank you doctor.
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