28/F with ?viral pyrexia?viral meningitis

 16th March ,2022 

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A 28 yr old female presented to the casualty with the 

C/O fever since 3days (high grade)

C/O loose stools since 3 days 

C/O nausea , vomitings since 4 days ( 1-2 episodes per day) 

C/O pain abdomen at the site of LSCS stitches.

C/O neck pain , C/O Generalized body pains since 3 days.

The subject was apparently asymptomatic 4 days ago, then she developed fever , which was high grade and continous, associated with generalized body pains and neck pain+ 

H/O passage of loose stools (watery in consistency) 

Nausea+ , H/O vomitings since 4 days {1-2 episodes /day } non bilious , associated with pain abdomen at the site of lscs which was performed 6 months ago. 

Not a known case of Diabetes MELLITUS , Hypertension. 

H/O LSCS ; 6 months ago 

No H/O SOB,cough, cold , burning micturition 

O/E : 

PATIENT IS C/C/C with vitals ON ADMISSION :

Temp: 98.4 degrees F ,( AFEBRILE) 

PR: 104bpm 

BP: 90/60 mmhg 

SPO2 @R.A: 98% 

RR: 18 cpm 

SYSTEMIC EXAMINATION : 

CVS :S1,S2 + 

RS : BAE+, NVBS +

PER ABDOMEN : TENDERNESS PRESENT @ Lower abdomen @ the site of stitches due to LSCS performed 6 MONTHS AGO 

CNS : NAD

Rx: 

1) IVF

             NS,RL@ 100ML/hr . 

             DNS @ 50 ml/hr 

2)  Inj. PANTOP 40 mg IV/OD .

3) Inj. ZOFER 4mg IV/OD 

4) Inj. OPTINEURON 1amp + 100 ml NS 

5) TAB. ULTRACET 1/2 tab Q.I.D 

6) TAB. DOLO 650 mg PO/TID 

7)Inj. CEFTRIAXONE 2gm/IV/BD 

8) Inj. DOXY 100 mg IV/BD 

9) Inj. Acyclovir 

INVESTIGATIONS 

CBP, LFT ,RFT ,RBS 

ECG: 

USG:abdomen 

OPHTHALMOLOGY REFERRAL 

PROVISIONAL DIAGNOSIS : ?VIRAL PYREXIA ? VIRAL MENINGITIS