A 60 Yr male with fever and Alterations in sugar levels,,

A 60 Year old male with chief complaints of fever since 7 days Alterations in sugar levels since 7days
CASE
This is a case of 60 yr old male who came with the chief complaints of fever since 7 days and Alteration in sugar levels since 7days 

History of present illness 
Patient was apparently asymptomatic 7 days back then he developed raise in temperature which was insidious in onset gradually progressive associated with chills and rigor temperature is aggravated during night and temporarily releived by medication.There is history of fatigue, Burning micturition.No H/O photophobia, decreased vision, pain abdomen, vomitings, loose stools, dark colored stools.No H/O bleeding manifestations.

Past history 
There is H/o Diabetes since 16 years 
No H/O Tuberculosis, Asthma, Hypertension, Epilepsy, Thyroid.

Family history 
There is no significant family history. 

Drug history 
Glimeperide,voglibose & metformin tablets are used.

Personal history 
DIET -Mixed
Appetite-normal
Sleep-adequate
Bowel &bladder -regular
Addiction - no addictions

General examination 
Patient was conscious, coherent, cooperative
No Pallor, Icterus, Clubbing, Cyanosis, Lymphadenopathy
There were no signs of dehydration.

Vitals
Temp: AFebrile 

PR- 73/Min    

RR- 18/Min

BP- 140/90 mmHg

Spo2 -99%at RA

SYSTEMIC EXAMINATION

Per Abdomen - shape of abdomen is obese. No tenderness and no palpable masses are found.
CVS- S1 S2 heard, no murmurs

RS- NVBS.

CNS- NFND

Tone, power and reflexes are normal.





Provisional diagnosis 
Viral pyrexia secondary to dengue with uncontrolled diabetes

Treatment 
Inj pipraz- 4.5gm/iv/BD
Tab Doxycycline 100mg/BD
Tab PCM 650mg/oral/BD
Inj PAN 4mg/Iv/OD
Inj Zofer 4mg/IV
Iv fluids NS@ 75ml/hr
Inj.Neomol 1gm/ml

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