A 35 YEAR OLD MALE WITH LIVER ABSCESS

 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box"


LIVER ABSCESS


35 year old male came to our hospital with chief complaints of upper abdomen pain since one week, fever since one week.

Patient was apparently asymptomatic 1 week ago, then developed pain abdomen which was insidious in onset, gradually progressive. Pain in right hypochondrium and gastric region with no aggravating and relieving factors.

Fever is on and off since one week, high grade not associated with chills and rigor, cold, cough, body pains, nausea vomitings, loose stools and constipation.

No history of bleeding manifestations.


PAST HISTORY

Not a k/c/o T2DM,HTN,asthma , epilepsy,TB 


PERSONAL HISTORY

Diet - mixed

Appetite - decreased since 1 week

Sleep- adequate

Bowel movements- normal

Addictions- alcohol, regular, since 10 years

Smoking, 10 pack years


General physical examination

Pt is conscious, coherent, cooperative, 

Icterus- present 

 Vitals-

Temp- afebrile 

Bp-110/70 mm hg

Pr- 86 bpm

Rr-20 cpm

Spo2- 98% on RA


Systemic examination

RS- bae+, nvbs

Cvs-S1 S2 +

P/A - tenderness + at right hypochondrium and epigastric region

Sluggish bowel sounds heard

Cns- nad







                  X ray erect abdomen




USG


FEVER CHART



ECG


Investigations

3/2/22

HB-10.2

TLC- 17,900

PLT- 5.1


Serum amylase- 60 

Serum lipase- 28


RFT

Serum urea- 37

Serum creatinine- 1.1

Sodium- 130

Potassium- 6

Chloride- 98


3/2/22

LFT

TB- 4.40

DB- 3.12

AST/ALT- 96/145

ALP- 586

TP- 5.3

Alb- 2.6

A/G- 0.94


PT -17 sec

APTT- 34 sec

INR- 1.25 









                     Surgery referral




Diagnosis
Liver abscess secondary to ? Amoebic or pyogenic 

Plan of treatment 
1. INJ. METROGYL 750MG/IV/TID
2. INJ. MAGNEX FORTE 1.5MG/IV/BD
3. INJ. PAN 40MG/IV/BD
4. INJ. THIAMINE1 AMP IN 100ML NS/IV/ OD OVER 30 MIN
5. INJ. TRAMADOL 1 AMP IN 100ML NS/IV/OVER 30MIN/ SOS
6. INJ. DICLOFENAC 3ML=75MG IM/BD
7. TAB. PCM 650 MG PO/QID
8. INJ. NEOMOL 1G IV/SOS








Comments

Post a Comment

Popular posts from this blog

72 year old female with uncontrolled diabetes.

Image
 Name - A. Rishi koundinya Batch - 2017 DR. RAKESH BISWAS (HOD). DR. SRI HARSHA (SR). DR. SHAILESH (PGY3). DR. KRANTHI (PGY1).  "This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box" CHIEF COMPLAINTS: Decreased appetite since 3days Shortness of breath since 3 days Vomiting since 2 days  HOPI: Patient is apparently asymptomatic 6 days ago there is an episode of fever 6 days back and relieved on medication and presented to OPD with chief complaints of decreased appetite since 3 days and vomiting since 2 days which is non projec
Read more

55years old patient with seizures.

Image
 May 12 , 2021 Student- A. Rishi koundinya Batch- 2017 This is an online e log book to discuss our patient de-identified health data shared after taking his/her/guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evidence based input This E blog also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 55year old male patient came to opd with c/o altered sensorium and involuntary movements from 11pm and recurrent episodes of seizures since 5yrs. Patient is
Read more

Intern assessment

 Name - A. RISHI KOUNDINYA Posted from 11/8/2022 to 11/10/2022 Current online learning portfolio 1. 72 yr old female with uncontrolled diabetes  https://rishikoundinya.blogspot.com/2022/08/54-year-old-female-with-uncontrolled.html?m=1 Learning impact - -Cases of constipation in diabetic female -Asymptomatic UTI vs symptomatic UTI -Should we give treatment for asymptomatic UTI if it is for long standing -Cranberry used as an treatment for asymptomatic UTI. https://www.researchgate.net/publication/233799462_In_vitro_activity_of_cranberry_extract_against_etiological_agents_of_urinary_tract_infections 2. 23 yr old female with fever https://rishikoundinya.blogspot.com/2022/08/23-year-old-female-with-fever.html?m=1 Learning impact- -Dengue management 3. 70 yr old male with fever and dribbling of urine https://rishikoundinya.blogspot.com/2022/08/70-year-old-male-with-fever-and.html?m=1 Learning impact- -Causes of Dribbling of urine -Management of nuerogenic bladder -Condom catheters 4. 49 yr
Read more