Thursday, January 13, 2022

29/M with fever and lower backache since 2 days

29 year old male came to casualty with complaints of fever and lower backache since 2 days.

Fever low grade, a/w chills and rigors, subsided on medication. Pain was dragging type, in lower back radiating to front.

Pt was apparently asymptomatic 1 year back, then presented to casualty with similar complaints along with decreased urine output hicupps and vomiting from 2 days, then developed involuntary movements of right lower limb for which he visited local hospital and on routine investigations was found to be hypokalemic, took some medication and the situation resolved. 6 months later he developed lower backache and investigations revealed renal calculi for which conservative management was done and complaints got resolved. then pt developed right sided involuntary movements again, went to local RMP, had 2 episodes of GTCS and referred to KIMS, NKP for further evaluation. Was diagnosed as ACUTE KIDNEY INJURY/NCC/TUBERCULOMA (2° seizures) and (in March of 2021) pt underwear 4 sessions of dialysis

NO H/O HTN,DM, TB,ASTHMA.CVA,CVD
OIE-PT CONCIOUS.COHERENT COOPRATIVE, GCS-15/15 
-NO SIGNS OF ICTERUS CYNOSIS.CLUBBING, LYMPEDEEMOATHY,GENERALISED EDEMA,
-VITALS-
BP. 140/BMMG PR.8ZBPM PR 18CPM.SPO2 98%AT ROOM AIR 
SYSTEMIC EXAMINATION -CVS-s1,82+ RS-BAE+ P/A-SOFT NON TENDER