32M WITH FEVER AND PAIN ABDOMEN
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Fever - 7 days.
cough -7 days
HOPI : Patient was apparently asymptomatic 7 days back, then he developed fever which was insidious in onset gradually, progressive, the fever was high grade in nature, increased during right, no aggravating factors & temporarily releived on medication. He also developed Pain in the abdomen; at right hypochonchiac region,Pain was of pricking type. The Pain was aggravated on deep inspiration & no releiving factors. Cough since 7 days insidious in onset gradually progressive non productive in nature no aggravating and releiving factors.
No Night Sweats, Post nasal drip.
No Constipation , Nausea, Vomiting, Loose stools, Blood in stools,No Abdominal distention.No increased or decreased output.
No Palpilations No hoarseness of voice.
History of Hospital admission 10 days back stayed for 3 days was not satisfied with the treatment then he Came to our hospital.
Pallor: absent
Icterus: absent
Cyanosis: absent
Clubbing: absent
Generalized lymphadenopathy: absent
Bilateral pedal edema: absent
Vitals:
Bp:120/80 mmhg
Pulse rate: 80 bpm
RR: 18 cycles per min
Temp: Afebrile.
SYSTEMIC EXAMINATION:
P/A:
INSPECTION:
Shape of abdomen- scaphoid
Umbilicus- inverted
No Scars, Sinuses and engorged veins.
No visible palsations, peristalysis
Palpation:
No local rise of temp
tenderness - right hypochondrium
No masses felt Spleen X Liver X
Percussion - No dullness
No Fluid thrill
No Shifting dullness
Aus -Bowel sounds heard.
RESPIRATORY SYSTEM EXAMINATION:
INSPECTION:
Trachea -central.
chest movements - Equal.
shape - elliptical.
No Scars, Sinuses and Engorged Veins.
No hollowing or crowding of ribs
drooping of shoulders
PALPATION:
All inspectory findings are confirmed.
No Local rise of temp
No tenderness.
trachea- central
Bilateral chest movements movements - Equal
TACTILE VOCAL FREMITUS: DECREASED IN MAMMARY, AXILLARY, INFRA AXILLARY AREAS IN RIGHT SIDE.
PERCUSSION: DULL NOTE IN RIGHT MAMMARY, INFRA AXILLARY ,AXILLARY AREAS
TIDAL PERCUSSION: DULL NOTE FROM 6TH ICS.
AUSCULTATION:
decreased breath sounds in right axillary, mammary, infraaxillary areas. Left side normal.
CVS: S1,S2 heard, no murmurs.
CNS: no focal neurological deficits
provisional diagnosis: pleural effusion right side.
INVESTIGATIONS:
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