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Case report CCMDDHF

Case report CCMDDHF. Baby senuka Age 5 month From Kudapaduwa Negombo.{Dengue endermic area}. History- Fever since 27/03/14 around 3pm had cough and cold not having vomiting, loose stools, bleeding menifestations

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Case report CCMDDHF

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  1. Case reportCCMDDHF

  2. Baby senuka Age 5 month From Kudapaduwa Negombo.{Dengue endermic area}

  3. History- Fever since 27/03/14 around 3pm had cough and cold not having vomiting, loose stools, bleeding menifestations Also had a history of fever and cough one week back and treated by a Gp. This time also treated by the same GP. Baby was not responded to treatment. Came to the DGH Negombo on the 29th of march Admitted to PCU and did a FBC

  4. WHAT ARE YOU GOING TO DO WITH THESE REPORTS…….. ARE YOU GOING TO EXCLUDE DENGUE????????????

  5. What has done in PCU Discharge the patient Ask to do a urine culture and show it to the hospital 30th of march urine culture report was shown to the doctor in the hospital which was negative Mother complained that child is still having fever. Doctor asked to do a repeat FBC

  6. NOW WHAT IS YOUR MANAGEMENT PLAN??????????? Doctor of the same ward has given co amxyclave syrup and told if the fever is not settling admit the patient on following day

  7. 31st of march patient has develop loose stools 4-6 times vomiting 3-4 times Came to the hospital in the morning Did a FBC Collect report from the lab around 4 pm

  8. WHAT DO YOU THINK NOW???????

  9. 31ST ON ADMISSION Hx- fever day 5 -loose stools -vomiting -cough -cold no bleeding manifestations

  10. Ex- afebrile BW-6.7Kg looks ill & less active IBD-6Kg not pale hydration good PR-120bpm Lungs-clear Abd-soft

  11. management Double cannula Fluids oral-17cc/hr maintainance-4.2ml/kg/hr Sy. PCM 5.5ml 6hly sos Sy. Eveline forte 4mt tds Patient transfer to the CCMDDHF

  12. investigations

  13. USS 31ST 8PM 1ST 10AM PT+PF 0.2cm 0.5cm FF in MP 0.2cm 0.5cm FF in Pelvis nil 0.8cm R/PE no 0.2cm

  14. NS1 positive on D5 IgM positive on D9 (negative on D7) IgG negative on D9

  15. Managed as DHF since 8pm 31st of march Leaking over at 8pm on 2nd of April Patient recovered slowly

  16. MESSAGE EVEN THOUGH THE INVESTIGATIONS ARE NORMAL IN THE INITIAL STAGE WE HAVE TO GO WITH THE CLINICAL EXAMINATION FINDINGS AND KEEP FOLLOWING UP THE PATIENT .

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