55 yr old female with Dengue fever

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New admission 

Amc bed 3:

A 55 yr old female who is a home maker came to opd with c/o fever since 4 days. 

Patient was apparently asymptomatic 4 days back then she developed fever which was high grade and continuous type,  didn't releive on medication.

 H/o 1 episode of vomiting 4 days back contents being food particles,  non bilious,  non projectile.  

H/o giddiness & fall 3 days ago.  

No c/o SOB,  pedal edema 

No c/o melena,  hemetemesis 

K/c/o HTN  since 2 yrs on medication ( Tab,. ATENELOL 50mg PO / OD ) 

She went to a local doctor 3 yrs back i/v/o generalised itching for which she was prescribed Tab. Prednisolone 10 mg PO/OD & was using it since then 

Not k/c/o DM,  asthma, thyroid disorders , epilepsy 

O/E : 

Pt is c/c/c 

Vitals : 

Temp: 99.4 f

HR: 78 bpm

RR : 20cpm

BP : 110/80 mm hg

Spo2: 99 @ RA

SYSTEMIC EXAMINATION : 

CVS : S1 S2  + . 

RS : BAE + NVBS + 

PA: soft, Non tender   

CNS :  NAD 

DIAGNOSIS : DENGUE  ( NS 1 POSITIVE)  

TREATMENT :

IVF - NS,  RL @ 100 ml / hr

Inj.  PANTOP 40 mg IV / OD 

W/F bleeding,  postural hypotension 

Inj. OPTINEURON  1 amp in 100ml NS IV/ OD 

INJ. NEOMOL 1 gm IV /SOS ( if temp > 101 F)  

Tab.  DOLO 650 mg PO/ TID 

INVESTIGATIONS : 

Usg abdomen :

Chest X-RAY PA view :

Ecg :