VIRAL PYREXIA WITH THROMBOCYTOPENIA WITH DENGUE NS1 POSITIVE

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A 20 year old male,who works in a sweet shop and a resident of khatanqur came to casualty with complaints of fever since 5 days. 

Patient was apparently asymptomatic 5 days ago then he developed high grade fever not associated with chills and rigors which was intermittent and with no diurnal variations. 

No h/o vomitings,loose stools 

No h/o cough,SOB 

No h/o burning micturition 

No h/o hematuria,melena, bleeding gums, hematemesis and no other bleeding manifestations 

Not a k/c/o DM, HTN, TB, CVA, CAD, Epilepsy 

He has normal appetite,takes mixed diet, regular bowel and bladder movements,no addictions.

On examination patient is conscious, coherent and cooperative 

No pallor, icterus, cyanosis, clubbing, lymphadenopathy,edema 

Vitals: 

Temp-99 degrees F 

PR-98 bpm 

RR-18 cpm 

BP-110/90 mm Hg 

Spo2:98% at room air 

GRBS-126 Mg% 

RS: Bilateral air entry+;clear 

P/A:soft,non tender 

CVS:S1S2+

CNS:NFD

Provisional diagnosis: Dengue NS1 positive with thrombocytopenia 

INVESTIGATIONS: 

CUE: 

Albumin-trace 

Sugar-nil 

Pus cells-3-4 

Epithelial cells-2-3 

RBS-109 Mg/dl 

Urea-26 mg/dl 

LFT: 

T.bil-0.69 

D.bil-0.18 

AST-50 

ALT-19 

ALP-128 

T.Protein-6.0 

Albumin-2.6 

A/G-0.76 

Sr.creatinine-1.4 

Na-138 

K-3.8 

Cl-98 

HCV-negative 

HBsAg-negative 

HIV-negative 

ECG:

TREATMENT:

1)IVF:NS,RL,DNS @100 ml/hr

2) PLENTY OF ORAL FLUIDS

3)INJ.PAN 40MG IV/OD

4)TAB.DOXY 100 MG PO/BD

5)TAB.DOLO 650 MG PO/SOS

6)LOOK FOR BLEEDING MANIFESTATIONS

7)INJ OPTINEURON 1AMP IN 100 ML NS IV/OD

8)GRBS 12TH HORLY

9)LOOK FOR POSTURAL DROP IN BP 

10)INJ.NEOMOL IF TEMP >101 DEGREES F IV/SOS