A 46 year old woman with fever and vomiting

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This is an online E logbook to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through a series of inputs from the available global online community of experts intending to solve those patients' clinical problems with collective current best evidence-based inputs

Chief complaint-
A 46 year old woman, residing in narketpally presented to OPD with the chief complaints of fever and vomiting.

History of present illness-
The patient was apparently asymptomatic 5 days ago but then developed fever with no diurnal variations.
She also complained of vomiting, decreased appetite and weakness since past 5 days.

Past illness-
No history of HTN, Diabetes, Asthma.
White patches seen on bilateral forearm, right hand and around mouth since 2 years.

Personal History-
Married.
Diet: vegetarian
Appetite: normal
Sleep: adequate 
Bowel and bladder: regular
Addictions: none

Family History-
No significant History 

General Examination-
Patient is concious, coherent and cooperative
Moderately built and moderately nourished
Pallor-absent
No icterus
No cyanosis
No Clubbing of fingers
No generalised lymphadenopathy
No pedal edema
Vitals-
Temp: 98⁰F
BP: 110/70 mm of Hg
Pulse: 72bpm
RR: 22 cpm
SpO2: 96% at room temp
GRBS: 95 mg/dl

Systemic examination-
CVS-
S1 and S2 heard

Investigations-
26/8/22

27/8/22

28/8/22

ECG-




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