A 18 year old male patient came to the causality c/o
Fever since 4 days
Fever- low grade, intermittent, associated with chills and nausea
H/o 2-3 episodes of vomiting on 2nd day of fever
No h/o loose stools or bleeding gums
H/o malena 1 episode
No h/o of hemoptysis, hematemesis
No h/o cold,cough,sob
No other complaints
PAST HISTORY:
No h/o DM, HTN, asthma, epilepsy, TB
PERSONAL HISTORY
Appetite-decreased
Regular bowel and bladder movements
No addictions
GENERAL EXAMINATION :
Patient is conscious, coherent and cooperative
No pallor, Icterus, cyanosis, clubbing, lymphadenopathy
VITALS :
Temp: 100.6F
PR: 76bpm
BP: 100/70 mm hg
RR: 20 cpm
Spo2 - 99%
CVS :
S1, S2 heard , No murmurs
RS :
Position of trachea: central
BAE present
PER ABDOMEN: Soft
And non tender
Bowel sounds +
CNS:
Patient is Conscious ,oriented to time,place and person
HMF -intact
Motor & sensory system: normal
Reflexes: present
Cranial nerves: intact
No meningeal signs
PROVISIONAL DIAGNOSIS-
Fever with thrombocytopenia(Ns1 positive)
USG abdomen
1)gall bladder oedema
2)moderate ascitis
Investigations