A 25yr old female
A 25 yr old female housewife by occupation resident of nalgonda came to general medicine OPD with
Chief complaints:-
Body pains since 6 days
Fever since 3 days
History of presenting illness:-
Patient was apparently asymptomatic 6 days back then she started developing body pains insidious in onset ,gradually progressive, dragging type symmetrical in nature small joints are involved more not associated with swelling local rise of temperature and redness,aggregated vated during fever no relieving factors
Fever since 3 days sudden in onset continues in nature high grade associated with chills and rigors relieving on medication no aggravating factors
Headache since 3 days during fever dragging type relived on medication and rest
History of Vomitings 4 days back projectile type non bilious 3-4 episodes
History of watery loose stools 4 days back 3-4 episodes
History of petechial rash on left fore arm one day of admission after applying Bp cuff
No history of cough,night sweats, abdominal pain,pedal oedema retro orbital pain.
Daily routine
Before
Wakes at 8am eats breakfast at 9am and then does the household work lunch at 1pm and at 5pm drinks milk and at 9pm eats dinner then sleeps at 11pm
After
wakes at 9am could not do household work she was feed by her mother she ate 1/4th of quantity of food sleeps from 2 to 6pm ate her dinner at 9pm and sleeps at 11pm
Past history
N/k/c/o diabetes mellitus hypertension tuberculosis asthma epilepsy cardiovascular diseases
History of LSCS 6 Months ago
Family history
Not significant
Personal history
General examination
Vitals :
Hess test: positive
Systemic examination :
CVS system
Respiratory system
Abdomen
CNS examination:
Provisional diagnosis
Investigations
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