48 YEAR FEMALE WITH SEPTIC SHOCK AND MODS 2° TO EMPHYSEMATOUS PYELONEPHRITIS
A 48 year female presented to opd with cheif complaints of fever since 10days •burning micturition since 3 days •Pain in B/l loin since 5days •Unable to pass urine Since 1 day •Altered sensorium since 1day HOPI: Patient was apparently asymptomatic since 19 days then she developed fever which was low grade, intermittent not associated with chills and rigors, relieves on taking medication.She was taken to another hospital for the same and the report shows Serum creatinine-1.8 CUE: pus cells loaded USG abd: left hydronephrosis •Burning micturition and B/L loin pain (colicky type) with no aggravating and relieving factors since 12 days •Decreased urine output and altered sensorium since 10days On admission, foley’s was passed and frank pus noticed. Patient had slurring of speech from 2 pm and then started speaking incoherently and couldn’t recognise anyone. Dialysis was initiated due to deranged RFT, Hypercalcia, metabolic acidosis to remove toxic metabolites. Past history: H/o renal