63 year old male patient with viral pneumonia

Name- M. Sri Nithya

Roll. No- 75


 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 a diagnosis and treatment plan. 


 


 


Following is the view of my case: (history as per date of admission)

63 YEAR OLD MALE PATIENT WITH VIRAL PNEUMONIA


63 year old male patient came to the hospital with the chief complaints of 

cough with expectoration since 6 days 

fever since 6 days 

shortness of breath since 6 days

myalgia since 6 days.


History of present illness.  

Patient was apparently asymptomatic 6 days ago then 

 He developed  cough with expectoration which is insidious in onset, progressive in nature, it is mucoid, minimal, non foul smelling and non blood stained. There are no aggravating factors , it relieved with medication.

History of fever since 6 days which is insidious in onset, high grade and intermittent type. It is associated with chills not associated with rigors.

He also has shortness of breath since 6 days which aggravates on exertion.( MMRC grade- 1 or 2).

          He has myalgia since 6 days.

He has no complaints of chest pain,wheeze or decrease in urine output

Past History

There is no history of TB, asthma, hypertension, diabetes mellitus, cardiovascular diseases.

No H/O previous surgeries.

There is H/O chest trauma  30 years back.

Personal history

Appetite- normal

Diet -mixed

 bowel and bladder -regular

Sleep- adequate

Addictions-He is a chronic smoker since 35 years

He is  chronic alcoholic since 40 years

No known allergies.


Family history

No significant family history.


General examination

Patient is examined in a well lit room with informed consent. 

He is conscious, coherent, co-operative,well oriented to time,place and person.

He is moderately built and moderately nourished.

Pallor - absent

Icterus - absent

Cyanosis - absent

Clubbing - absent

Lymphadenopathy - absent

Edema - absent


Vitals:

Temperature-afebrile
Heart rate-90 beats/min
Blood pressure-110/70 mmHg
Respiratory rate-29cycles/min
SPO2-98% at room air

SYSTEMIC EXAMINATION:

CVSS1 and S2 heard
         No added thrills, murmurs

RESPIRATORY SYSTEM

Trachea is central,
Normal breath sounds on the right side and Crepitations were heard on the left side


CENTRAL NERVOUS SYSTEM: 
Level of consciousness : conscious to time, place, person
Speech: normal
Cranial nerves -Normal
Motor and sensory: normal 


INVESTIGATIONS
















Diagnosis: Left lower lobe consolidation due to viral pneumonia_?

Treatment:

Inj. Ceftriaxone 1gm/IV/day
T.Azee 500 mg -10 days
T.mucinae-600 mg tab in gram of water-BD
T. Pcm-650 mg
Neb. Budesonide -8 th hourly
          Duolin -6 th hourly
Syp. Ascoril- 2 Tsp - TID
Monitor vitals.





































































 

























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