Generalized muscle ache

Chief Complaint A 45 y/o female came for fever, headache & muscle ache, and swelling of both arms. History She had urinary track infection 10 days back and taken antibiotic course for that. Vitals Vitals are wnl Investigations BP: 110/70 mmhg, Resp rate: 17 bpm, HR: 75 bpm, Temp: 101 degree F. O2 saturation-99% on room air. Examination Cardiac and pulmonary exam normal. Abdomen was tender to palpation. Arms and legs muscles are also tender to palpation. Investigations WBC: 14500/mm3, Hb: 11.7 g/dL, Platelets: 289,000/mm3 Total bilirubin: 1.8 mg/dL, direct bilirubin: 1.4 mg/dL, AST: 59 u/l, ALT: 127 u/l, Alkaline Phosphatase: 337 u/l Urine analysis shows presence of wbcs. Treatment Please give your advice.

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Hepatitis developing after initial treatment given for UTI which still shows pus cells and hemogram shows leucocytosis LFTS are deranged So in my opinion it is drug induced hepatitis with jaundice or bacterial hepatitis Rx iv fluids Inj dexamethasone Inj Ceftriaxozone Inj pantaprazole Inj ondestron Inj hepamerz Send urine for c&s Multivitamins Once settled down shift on oral treatment

Thanx dr Rajendra Rai
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Do urine culture sensitivity. Abdominal ultrasound to see for any hydro/ pyelonephrosis. Also to rule out appendicitis and other causes of acute abdomen Start syp cital tds. Novefos 1 sachet in 1 glass of water HS once after collecting urine for c/s

Jaundice with u T L X RAY CHEST and USG Abdo. Urine complete and sensitivity RT -PCR 2unxer present circumstances covid 19 must be ruled out and protocols must be followed. Needs further investigation and evaluation to conclude and line of treatment.

Thanks Dr Vipin Bihari Jain
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Recurrent urinary tract infection Please do USG abdomen and KUB to look for cause of recurrent urinary tract infection Look for stone disease, hydronephrosis and look for post void residue as cause of recurrent urinary tract infection Do urine routine and culture Antibiotic according to culture and sensitivity

Here are possibilities Recurrent UTI with jaundice Sub clinical hepatitis Acute cholecystits Pancreatitis Appendicitis Rull out covid 19 Adv: urine c/s, USG abdomen, s, amylase,

Viral hepatitis. Urine to be re investigated Micro & CS. It can be relapse of UTI. USG And & Pelvic. Execute fluid intake. Antibiotic as par sensitivity recommendation. Alkalizer.

?UTI SECONDARY TO VIRAL HEPATITIS USG ABDOMEN URINE FOR C/S CBC,ESR, ANTIBODY ANTIGEN FOR MP,WIDAL,IGG IGM NS1 DENGUE, AND RTPCR FOR COVID-19 TO CONCLUDE

Thanks Dr. Vipin Bihari Jain
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Urine culture and sensitivity Urine routine and microscopic Ultrasound KUB and abdomen Mostly uti or renal calculus

Thanks Dr. Ashok leel, Dr. Dinesh Gupta, Dr. A Dutta, Dr. Gyanendra Tripathi
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? JAUNDICE..WITH.. UTI ..

Tnx Dr Saurabh Burkul..
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Looks like uTI Do urine cult n sensitive Also. RT.PCR

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