fever

A 40 year old male, labourer by occupation came with c/o 
1.fever since 5 days 
    High grade, Associated with chills 

2. Cough since 5 days
      Productive type, with mucoid expectoration
      
The patient was apparently assymptomatic 5 days ago and then he developed fever which was high grade , associated with chills and cough which is productive with mucoid expectoration
Loose stools 7 episodes - 3 days ago 
Not associated with nausea, vomiting,burning micturition.

Past h/o
K/c/o - HTN since 3 years 
Amlodipine 5 mg
Metoder xl 50 mg 

Not a k/c/o DM, asthma , epilepsy, TB, CVD

PERSONAL HISTORY
He takes mixed diet
Appetite - normal
Sleep - adequate
Bowel and bladder movements- regular
Addictions - drinks alcohol occasionally and chews betel leaf

On general physical examination

Patient is conscious,coherent, cooperative

Moderately built and nourished 

No pallor ,icterus,clubbing,edema of feet,koilonychia, edema of feet

Vitals:-
Temperature- 101.2° F
Pr- 84 BPM
BP- 170/110 mm hg
RR- 18 cpm
Spo2- 99% at RA
Grbs- 154 mg%

Systemic examination
CVS- S1 S2 +
RS- BAE+
P/A - soft,nontender 
CNS- NAD

Investigations:-
Hemogram -
Hb- 15.3 gm%
Tlc- 2200
Plt- 24000
Pcv- 42.3
Mcv- 80.7
Mchc- 36.2

Blood group - O negative 

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