SOB in Hodgkin lymphoma case

Chief Complaint A 67 y/o male presented with fever, tiredness, and shortness of breath. History He has had autologous stem cell transplant for Hodgkin lymphoma 1 month back. After 5 days of transplant he complains of hypoxemia which was resolved with medication. He also has h/o prostate cancer 10 years back treated with surgery and chemotherapy. Vitals BP: 130/80 mmhg, RR: 17 bpm, Pulse: 76 bpm, Temp: 102 degrees F, oxygen saturation was 100% on ventilation. No wheezes noted Investigations Blood report & LFT wnl. But magnesium: 1.7 mg/dl, potassium of 3.5 mmol/L, total protein of 5.1 g/dl and albumin of 2.7 g/dl. Hb: 9.2 g/dl and hematocrit of 27.4%, platelet count of 81 7 K/μl, WBC: 20.1 K/ μl. Treatment What next should be done?

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Leucocytosis more than 20000 suggesting septicemia and hence all symptoms of sob fever tiredness Pt has anaemia with thrombocytopenia and low hematocraits Hypoproteinemia with reverse A/G ratios and magnesium phosphorus are also reversed H/o past prostatic CA and now hodgkins Pt is is on ventilation Likely LUTS Inj meropanum Or inj piperacillin+inj tazobactum Adv for PSA Retrograde cystoscopy or mcu Correct anaemia may require BT Pt may be on steroids and immunosuppressants hence take an opinion of treating hematologist Adv xray chest Usg abdomen

Thanx dr Kute Ankush
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NEED'S.. SPECIFIC .. TREATMENT PLAN.. DEPENDS ON.. AGE & GENERAL HEALTH.. AND .. TEAM . MDT .. AS IN THIS CASE..THERE IS .. ANEMIA.. LEUKOCYTOSIS.. NEED'S.. BT .. HEMATINIC'S.. BS..ANTIBIOTICS.. STEROIDS.. IMMUNOSUPPRESSANT.. HEMATO ONCOLOGISTS OPINION IS.. ALWAYS BETTER..

Tnx Dr Ashok Leel sir
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HODGKIN'S LYMPHOMA THIS IS RAS VHA SROTO VYADHI.USE TIKTA RAS USHAN VEERYA DRUGS FOR INTERNAL USE AND TIKTA SHEET VIRYA DRUGS FOR LEPA .WITH IN 1 MONTH U GET RESULT.OR CAN USE DASHMOOLA DRUS FOR LEPA PURPOSE

Needs further investigation and evaluation to conclude till reports complied. BT BS ANTIBIOTICS IMMUNOSUPPRESSANT X RAY CHEST USG ABDO.

Thanks Dr Kute Ankush
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Hematologist And urologist opinion Then BT

Haematinics,immunosuppressants, antibiotics..needs further evaluation..