Wednesday 4 November 2020

52 yr male with ARF secondary to Rt pyelonephritis ?PCKD

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CASE PRESENTATION

52year old male came with cheif complaints of pain abdomen since 10days,pain in peri umbilical region and left iliac region since 10days,pedal edema (subsided),backache since 10days,no h/o vomitings,nausea,sob , palpitations,burning micturation

Alcoholic since 10years(local liquor)

Chutta (smoking)since 10days 2 to 3 times/day

C/o fever since 10days on and off intermittent associated with chills and rigors

Personal history

Decreased appetite

Sleep adequate

Bowel and bladder regular

Alcoholic since 10years(local liquor)

Chutta (smoking)since 10days 2 to 3 times/day

O/E

 Pt c/c/c

Pallor Present 

No cyanosis, clubbing,  pedal edema, lymphedenopathy

BP - 110/70 mmhg

PR - 88 bpm

CVS - S1S2

RS - BAE+

CNS No FND

P/A tenderness + in periumbilical region and left iliac region,mild hepatomegaly+

INVESTIGATIONS

BEFORE DIALYSIS


AFTER DIALYSIS


DIAGNOSIS - ARF SECONDARY  TO RT PYELONEPHRITIS 

                        ? PCKD


TREATMENT -

1. IVF 2 UNITS 0.45% NS , 1 UNIT RL

2. INJ PIPTAZ 2.25 GM/IV/QID

3. INJ LASIX 40mg IV/BD

4. INJ PAN 40 mg IV/OD

5. CIPROFLOXACIN 500 mg PO BD

6. TAB NODOSIS 550 mg PO BD

7. TAB SHELCAL 500 mg PO OD










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