A 24 year female presented with abdominal pain, vomiting and fever

A 24 year old female who is a primi gravida housewife by occupation, resident of nalgonda came  to opd with the chief complaints of

•  Fever since 4 days

•  Suprapubic pain 4 days back

• Vomitings  since 2days

HISTORY OF PRESENT ILLNESS -

The patient was apparently asymptotic 4 days back then She developed fever which was insidious in onset, intermittent in nature and is of high grade which was  assosiated with chills and rigors, and  subsided on medication.

First she went to government hospital for antenatal checkup, after 3 days she developed fever and went to  government hospital on the same day and  diagnosed  positive for ns1 antigen (dengue positive). The doctors over there referred her to our hospital.

She had a h/o  suprapubic pain after voiding 4 days back , which was of dragging type, and it has gradually decreased in its intensity, but she complains of slight bursts of pain sometimes.

She also complained of vomitings - 2episodes/day immediately after consumption of food containing food particles which was non bilious,non projectile, non foul smelling and non blood stained.

C/o of Burining micturition

She no h/o loose stools, rash, hematuria, malena 

PAST HISTORY -

She is not a known case of diabetes, hypertension,asthma,cad,epilepsy,tb.

PERSONAL HISTORY -

Diet-mixed  

Apetite -normal  

Bowel and bladder movements -normal 

Sleep - adequate 

Addictions -none 

FAMILY HISTORY -

Not significant 


MENSTRUAL HISTORY- 

Age of menarche -16 years 

Cycles- regular 3/28 

Pads used per day -3 

Pain,Bleeding,Clotting- absent 

MARITAL HISTORY- 

Duration of married life - 1 and half year

Non consanguinous 

OBSTETRIC HISTORY -

LMP 15/2/22

EDD  22/11/22

SEDD 20/11/22

Gestational age - 28weeks 


T1 :

Conceived spontaneously 

UPT done after 5 days of missed periods

Folic acid taken

Early scan done

H/o vomiting relieved spontaneously 

No h/o radiation exposure,bleeding or spotting pv



T2 :

Quickening felt at 5th month 

TIFFA done

Iron calcium not taken regularly 

No h/o pain abd,tightening 

H/o occasional pedal oedema,receiving on rest 

No h/o UTI,headache,epigastric pain,blurring of vision. 

GENERAL EXAMINATION -

Patient is conscious, coherent and cooperative and well oriented to time, place and person.

moderately built and nourished.

Pallor-absent

Icterus-absent

Cyanosis-absent

Clubbing-absent

Lymphadenopathy - labsent

Edema-absent

VITALS -

Temperature- 98.6*F       

Bp- 150/100mm hg                

Pulse-78bpm

RR - 20cpm

SPO2 -98% at RA

SYSTEMIC EXAMINATION-

CVS- s1 s2 heard, no murmurs  

RS - BAE+ 

CNS - intact 

P/A - soft and non tender ,bowel sounds heard 


INVESTIGATIONS 

PROVISIONAL DIAGNOSIS 

NS1 positive (Dengue fever)


TREATMENT - 


1. Inj. Cefotaxim /gm/IV/BD 

2. IVF. 10NS and 10RL - 75 to 100 ml/hr 

3. Strict IO charting 

4. Inj. Zofer 4mg/IV/TID 

5. Inj. Pan 40 mg iv/od 

6. BP/PR/RR/spO2 charting 

7. Tab. Paracetamol 650gm po/QID 

8. Inj. Pcm 

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