A 14 years old girl came to the opd withfever since 5 days.

 

Chief complaints: fever since 5 days

History of present illness: Patient was apparently asymptomatic 5 days back then she developed fever. Fever was associated with body pains and subsided after medication. The temperature used to rise in the nights. Patient developed cough since 2 days. 


Past history: No similar complaints in the past 

Personal history: 

Diet: mixed

Appetite: normal 

Sleep: adequate 

Bowel and bladder: regular 

Addictions: none

Family history: not significant 

General physical examination: 

Patient is conscious, coherent and Cooperative, well oriented to time place and person. Moderately built and nourished.

Vitals : 

BP:

Pulse rate: 

Respiratory rate: 16

Temperature: afebrile 

Pallor: present ( very pale)



  Icterus: absent 


Cyanosis: absent 

Clubbing: absent 

Lymphadenopathy: absent

Edema : absent 


Systemic examination: 

CVS : S1 S2 ++ no murmurs heard 

RESPIRATORY SYSTEM: Normal vesicular breath sounds heard.

ABDOMEN :Soft nontender, mild speenomegaly present 


CNS: No focal neurological deficits. 

Diagnosis: severe anemia 


Investigations: 

As on 25/8/22 

 Treatment

1. Inj Iron sucrose IV  infusion
2. Tab Orofer xt x3months 

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