A 50 year old woman with fever, pain in her thighs and knee joints

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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 50 year old woman, resident of thaalakunta, a labour worker presented to OPD with chief complaints of fever, pain in her thighs, knee joints, chills and swelling in legs

History of present illness-
The patient was apparently asymptomatic 3 years ago but started experiencing pain in her knee joints 
She went to the local hospital where she received medication to relieve her pain
She then started having fever associated with chills only during the nights after long working hours since 15 days for which she took DOLO 
She also had pain in her thighs and knee joints since 15 days
Her legs were swollen since 3 days 
For which she visited a local hospital
On Investigations, it was found that she had decreased platelet count, low hemoglobin concentration in her blood and kidney problem(which the patient is not aware of) and they suggested her to go for a check up here
She then presented herself to our OPD with the already mentioned complaints and got admitted Saturday night

History of past illness-
No h/o HTN, Diabetes, Asthma

Personal History-
Diet: mixed
Appetite: decreased
Sleep: adequate 
Bowel: irregular
Bladder: regular but frothy urine
Addictions: none

Surgical History-
Appendectomy since she had Appendicitis and Hysterectomy 20 years back(i.e., her last pregnancy#5) because of presence of some lump in her uterus

General Examination-
Patient is concious, coherent and cooperative
Poorly built and moderately nourished
Pallor-absent
No icterus
No cyanosis
No Clubbing of fingers
No generalised lymphadenopathy 
Presented with swelling on her legs but decresed after medication Sunday night

Vitals-
Temp: 99.6⁰F
BP: 110/90mm of Hg
Pulse: 92 bpm
RR: 20 cpm
SpO2: 96% at room temp
GRBS: 113 mg/dl


Systemic Examination-
CVS- s1, s2 heard

Investigation-
HEMOGRAM-

LFT-


USG-
X ray-


ECG-


Fever chart-







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