FEVER,SOB IN A DIABETIC PATIENT

50yrs/F presented with worsening dyspnea and intermittent fevers.× 3days.The patient was hypoxic with an oxygen saturation of 85% on room air while at rest,decreasing to 75% on ambulation.Saturation not improving on high flow mask.She was tachycardiac and tachypneic with respiratory rate of 46.D dimer -2300,CRP -245.TLC -2500, Neutrophils -90, Lymphocytes -7, Eosinophil-0,Monocytes-1 Chief Complaints SOB,fever History Diabetes Vitals BP -110/70,Spo2 -85%,RR -46 Physical Examination Chest - B/l Crackles Investigations D dimer -2300,CRP -245.TLC -2500, Neutrophils -90, Lymphocytes -7,LFT Deranged,KFT normal Eosinophil-0,Monocytes-1 COVID 19 PCR - POSITIVE Awaited Diagnosis DIAGNOSIS? Management PLAN?

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A case of COVID-19 viral pneumonia. Findings in favour of COVID-19 viral pneumonia are 1.X -ray - chest - bilateral pulmonary parenchymal involvement 2 HRCt - Ground glass opacities- bilateral Crazy Pavement pattern- bilateral 3.Chest Examination- bilateral crackles 4.D- Dimer - 2300 - raised CRP - 245 - raised 5.Leukopenia , lymphopenia , Eosinopenia and Neutrophilia 6RT - PCR- Positive 7.RR - 46 , SPO2, 85%. Management Plan 1.High flow nasal oxygenation and remain prepared for Mechanical ventilation if required. 2.IV fluids- in restriction 1000 ml in 24 hrs, 3.Inj ceftriaxone 1 gm + sulbactum 500 mg IV - B.D 4.Inj Dexamethasone 6 mg per day 5.LMWH 6.Inj Remdesivir as per the protocol

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COVID virus Infection. X Ray chest B/ L pulmonary parenchymal involvement. Ventilation high nasal o2 required Iv infusion to correct electrolytes imbalance and maintain line maximum 1lt . Maintain IO Chart. Inj ceftam 1gm iv bd slowly. Inj dexona iv bd slowly. Inj PCM 1 amp I'm sos. Inj ramdesivir as per protocols of COVID pandemic issued by ICMR. Good nutritious balanced diet.

Thanks Dr Kute Ankush
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IT'S A..CASE OF.. DM-II .. WITH.. COVID-19 POSITIVE.. BL .. ILD..PNEUMONITIS.. WITH ASSOCIATED COMPLICATIONS.. NEED'S.. MANAGEMENT AS PER PROTOCOLS FOR COVID-19 BY..ICMR..

Tnx Dr Ashok Leel sir
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Guarded prognosis Pneumonitis COVID infection Ad to admit in COVID hospital

Thank you doctor
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Prognosis poor ' DM2 with viral PNEUMONITIS put on ventilator and treat as per GUIDELINE of COBID-19

Pure case of sarscov2 With Koch's Cbnat rtpcr Hrct score Ards Ild Admit treatment as per icmr guide line

SUGGESTIVE. OF A R D S SEVERE PNEUMONITIS

Bilateral pneumonitis

ARDS Fissure effusion Covid 19

Viral pneumonia(Covid 19) With DM2 Must hospitalised

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