Numbness of both feet

Chief complaint A 64 year old female complained of swelling in her right foot and leg along with numbness of the foot. She is not able to move her leg. This complaint only for 2 days. History Past surgical history include c section 32 years back. Family history include CVA in father. Investigations NA-124 k-4.2 Cl-91 CO2-21 BUN-14 Creatinine-0.5 Glucose-102 WBC-19.9 PLT-649 Diagnosis What is your opinion?

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Leucocytosis 19.9 Hyponatremia sr Na 124 This suggest pt is in sepsis Swelling rt lower limb with numbness likely has DVT Adv colour doppler study Ecg is WNL Xray chest suggest covid19 pneumonitis b/l So in summary it looks a c/o covid19 with sepsis and probably dic Adv sr ferritin and D-dimer Treatment will need aggressive mx with broadspectrum antibiotics like inj Ceftriaxozone inj azithromycin Inj LMWH Inj dexamethasone 02 supplement Antivirals as per protocol

Thanx dr Vipin Bihari Jain
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*DVT (rt foot ) Lt badal haziness suggestive of Pneumonitis RBBB with sinus tachycardia. Needs further investigation and evaluation to conclude and protocols of COVID 19 must be followed and ruled out. Regular monitoring and constant evaluation required.

Thanks Dr Dinesh Gupta
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SUGGESTIVE. OF.. SEPTICEMIA D. V. T..?? SECONDARY. TO INFECTION. AND THROMBOCYTOSIS.. ADVISABLE... CULTURE. AND. SENSITIVITY COLOR. DOPPLER. STUDY... ... USG.....CHEST. AND. WHOLE. ABDOMEN

Left basal haziness present suggest of Pneumonitis. Sinus tachycardia with RBBB Leucocytosis present Broad spectrum antibiotics Nebulize LABA LAMA Get Hrct chest and LS spine Xray

Thanks@Dr. Dhaval Acharya
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CXR.. RT.. APICAL AND..LT.. BASAL HAZINESS.. ECG.. SINUS TACHYCARDIA.. LEUKOCYTOSIS.. ? ILD.. ? PNEUMONITIS.. NEED'S.. HRCT.. 2D ECHO STUDY.. RT..PCR..COVID-19..

Tnx Dr Vipin Bihari Jain
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Bil hyperinflation Rt hemidiaphragm is markedly raised. Left basal heziness seen. Adv CECT thorax.

Rt dome raised adv Ultrasound abdomen and chest. May be CT later on

Left basal pneumonia,? Synpneumonic Leucocytosis Sinus tachycardia ? DVT right foot , with pulmonary embolism Hyponatremia PLT ? 649 ? Suggest Venous doppler of right LL CT chest Suggest antibiotics, correction of hyponatremia. Treatment according to results of investigations.

X ray chest shows left costophrenic angle blunting and haziness in left lower zone - this along with raised WBC count may suggest left lower zone consolidation with effusion Adv - HRCT chest Swelling in right foot - venous Doppler need to be done to rule out venous thrombosis

Respectable Dr Kunal shah, why we are bothered about ECG and x ray when patient does not have relevant complaints. Forget ECG and x ray. Patient has paralysis of right leg. Think about anterior cerebral artery territory ischemia Reflexes? Tone? Ct scan brain

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