14 year/ Female with H/O Fever 6 days ago

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I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan

 14 year Female Presented with H/O  fever 6 days back 

No Fever Since 4 days , 

No H/O Nausea, Vomiting, loose stools

NO H/O Bleeding manifestations , Bleeding gums (-), Malena (-).

Patient was apparently asymptomatic 6 days back  then she developed Throat Pain For Solids & Liquids, Followed by Fever which was continuous  and associated with Chills, Not relieved with medication on day 1, and on day 2 fever decreased on taking medication. She came to hospital for further evaluation.

Menstrual History: 

AOM: 12 years,

Cycles: irregular, bleeds for 5days, Not A/w  Pain & clots

LMP : 27/ 09/21.

Personal History:

Diet: Mixed 

Appetite: Normal

B & B: Regular

Sleep: Adequate

NO Addictions

On General Physical Examination: 

pt is c/c/c , Moderately built And Nourished.

No Signs of Pallor , icterus,  cyanosis, clubbing, lymphadenopathy,  Pedal Edema.

Vitals:

Afebrile, BP: 110/70mm Hg, 

PR: 88 bpm, RR:20cpm

Sp02:99% at RA.

CNS: S1 S2 +, no murmurs.

RS: BAE+, NVBS +.

CNS: HMF intact, NAD.

P/A: Soft, Tenderness + in Rt hypochondrium.

Investigations:

On 30/09/21














 
On 01/ 10/21: 







On 02/10/21: 
 
 
 On 03/10/21:
 
 
On 04/10/21:



Treatment : 
Day 1:
1. IVF - NS, RL, DNS @  100ml/ hr
2. Inj. PANTOP 40mg /IV/BD
3. Inj. OPTINEURON 1 Amp in 100 ml NS /IN/0D
4-TAB. MVT- P0/OD
5. W/F Bleeding Manifestations 
6. Temperature Charting 4 th hrly
7. Inj.NEOMOL IV SOS

Day 2: 
1. IVF - NS, RL, DNS @  100ml/ hr
2. Inj. PANTOP 40mg /IV/BD
3. Inj. OPTINEURON 1 Amp in 100 ml 
4-TAB. MVT- P0/OD
5. W/F Bleeding Manifestations 
6. Temperature Charting 4 th hrly
7. Inj.NEOMOL IV SOS

Day 3:
1. IVF - NS, RL, DNS @  100ml/ hr
2. Inj. PANTOP 40mg /IV/BD
3. Inj. OPTINEURON 1 Amp in 100 ml
4. W/F Bleeding Manifestations
5. Temperature Charting 4 th hrly
6. Inj.NEOMOL IV SOS

Day 4:

1. IVF - NS, RL, DNS @  100ml/ hr
2. Inj. PANTOP 40mg /IV/BD
3. Inj. OPTINEURON 1 Amp in 100 ml
4. W/F Bleeding Manifestations
5.Inj.NEOMOL IV SOS
6. Temperature Charting 4 th hrly

























 





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