Friday, August 2, 2013

dengue

22/7/13 @ 2330. @ ED Hosp Banting.

25years old/ malay/ lady
no known medical illness

p/w
fever x4/7 w chills and rigor. started on friday 19/7/13
diarrhea x 4/7 loose watery stool. 2x/d
rashes x1/7 on L UL.

a/w
LOA
malaise, lethargy
headache and dizziness
nausea

otherwise no vomiting, no myalgia/arthalgia, no retroorbital pain
living in dengue prone area (kg baru)
no hx of recent fogging. last- few months ago
no hx of recent travelling, or swimming in lake/river.

LMP 16/7/13. regular.

Family hx: NAD

surgical hx: lasik in 2012  NAD

past hx: no known medical illness, 1st hospitalization.

o/e:
conscious, alert, pink, crt less than 2s, good pulse volume, warm peripheries.
BP 90/60
HR tachy
T 39
RR 20
lung: clear. BEAE
CVS: DRNM
PA: tender on epigastric area, soft, BS present

FBC: WBC 2.8 Hct 40.2 Plt 131.

imp: viral fever TRO DF. Day 4 of illness, febrile phase. with warning signs.

Plan:

  1. IV omeprazole 40mg BD.
  2. T. PCM 1g PRN
  3. IVD NS 10ml/kg/H then reasses
  4. FBC 4hourly
  5. vital signs 2hourly
  6. to inform if HR more 120, BP less 90/60
  7. w/o warning signs
  8. encouraged orally

*******

it sucks to be a patient. new record, i slept 40hours straight at onset of the illness. and i got 11 days MC for that. not very good though because i hv to replace my MC working days. tsk.