This patient 30 yrs old with complaints of Weight loss , fever (on/off) and diarrhoea since 1 month was admitted in ED......suspection of Immunocompromised State was there and Reports are awaited....The pt is having high grade fever and his initial reports are given....Discuss the treatment approach



Appears to be in immunodeficient state. Anemia with hypoproteinaemia Pre renal azotemia With electrolyte imbalance Get sero reports Get PT/INR APTT done Get chest x ray as well as USG abdomen Packed cell transfusions needed. Multivitamins Inj thiamine Start empirically on an antibiotic TPN might need

IDAwithhypoproteinemia with ch renal failure. Request for more investigation. Cardiomegaly is one more matter of concern.

Patient appears to be seropositive.Its typical AIDS stage. Tongue appears red and Bland mistaken for alcoholism or vitamin deficiency but on investigations and culture comes out Candida Albicans and responds to AntiFungals.Severe Weight Loss and appetite, Appears to be Tuberculosis.Cardiomegaly suggests Pericardial Effusion,Pericardial tap under 2D echo would help for diagnosis

X-ray showing cardiomegaly with tiny infiltrates in left upper lobe Rule out serostatus and advised ultrasound abdomen

This pt was found to be HIV being investigated further with CD4 count

Possibility of immunocompromised state very high.. CxR shows cardiomegaly.. pericardial effusion likely.. Need one USG whole abdomen to look for adenopathy..? Koch's.? Lymphoma..

Advised HIV test. Is he known alcoholic,how are the liver enzymes,serum ferritin, x-ray showing cardiomegaly advised 2DECHO Injection Thiamine with MVI drip,packed cell transfusion, sure potkhlor for hypokalemia,ors

I agree c Dr. S. K. R Naik

HIV test

I agree with Santoshkumar Nayak. I advise for HIV testing

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