Fever with hyperglycemia

Female patient of age 45 comes in emergency Chief Complaints Fever two days high grade Body pain extreme Two shots of vominting yesterday No history of taking medication for Htn No history of cough/cold History History of taking medication for dm but not regular Vitals Bp:110/70 Rbs:390 Temp:102 Spo2:96 Physical Examination Anemic+ Pallor+ PA: tenderness over right upper quadrant Investigations I Advice Fever profile Lft Kft Hb1ac Urine rm Diagnosis Viral?? Widal?? Hepatitis?? Management Need Advice

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? PYREXIA WITH.. VOMITING.. UNCONTROLLED DIABETES.. HT .. MANAGEMENT.. HEMOGRAM.. URINE ROUTINE.. BSR..HBA1C.. LFT..KFT.. SR .. AMYLASE.. USG..ABDOMEN.. MEANWHILE TREAT SYMPTOMATICALLY..WITH.. IV..FLUIDS NS . PPI.. ONDANCETRAN.. CEFTRIAXONE 1GM.. SYMPTOMATIC T/T..

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Poorly controlled diabetes with acute onset fever, bodyache and vomiting can be viral as well as due to an overwhelming bacterial infection. R/o liver abscess/hepatitis/cholangitis, pyelonephritis/perinephric collection, pneumonia. Adv blood and urine culture, CXR, USG abdomen also along with SARSCOV2 rtPCR. Control Plasma glucose with insulin. Empiric antibiotics: Vancomycin + gentamicin + metronidazole.

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High grade fever in pandemic, needs to be considered as Covid 19 unless proved otherwise RT PCR for Covid 19 is important Empirical treatment for viral fever until reports are available Strict control of blood sugar with insulin Basal bolus insulin 10 units glargine insulin once a day 6 units human regular insulin with each meal Monitor blood sugar and adjust dose according to blood sugar

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