AKI ON CKD SECONDARY SEPSIS ?NSAID ABUSE

Case History and Clinical Findings
 C/O FEVER SINCE 10 DAYS HEADACHE WITH GIDDINESS SINCE 10 DAYS
HOPI-:
 PATIENT WAS APPARENTLY ASYMPTOMATIC 10 DAYS BACK,THEN DEVELOPED FEVER,HIGH GRADE,ASSOCIATED WITH CHIILS,INSIDIOUS IN ONSET,GRADUALLY PROGRESSIVE,ASSOCIATED WITH HEADACHE,GIDDINESS SINCE 10 DAYS. C/O HEADACHE DECREASED SINCE 2 DAYS H/O BURNING MICTURITION H/O DECREASED URINE OUTPUT PRESENT H/O PEDAL EDEMA O AND OFF SINCE 10 DAYS,SINCE 6-7 MONTHS NO H/O COUGH COLD NO H/O CKD N/K/C/O HTN,DM,CAD,CVA,THYROID DISORDER,EPILEPSY
 Investigation
 HEMOGRAM HB-6.3GM/DL TC-19500 N-86 L-10E-2 M-2 B-00 SMEAR-NORMOCYTIC NORMOCHROMIC HIV-NEGATIVE HBSAG-NEGATIVE HCV-NEGATIVE
Diagnosis
 AKI ON CKD SECONDARY SEPSIS ?NSAID ABUSE
 Treatment Given
 1) IVF 1 NS@75ML/HR 
2) INJ.LASIX 20MG IV BD 
3) INJ.NODOSIS 500MG PO/BD
 4) INJ.NEOMOL 1G IV 
5) MONITOR VITALS 4TH HRLY
 6) INFORM SOS
 Advice at Discharge
 LAMA NOTES PATIENT ATTENDERS HAVE BEEN EXPLAINED IN THEIR OWN UNDERSTANDABLE LANGUAGE ABOUT THE CONDITION ASSOCIATED WITH THE CONDITION OF DERANGED RENAL PARAMETERS OF SR.UREA 210 AND SR.CREATININE 7.2 . A 62 YEAR OLD MALE PATIENT BROUGHT TO CASUALITY CC/O FEVER ON AND OFF SINCE 10 DAYS.DECREASED URINE OUTPUT SINCE 5 DAYS.BILATERAL PEDAL EDEMA SINCE 10 DAYS BACK SUBSIDED AFTER TAKING OUTSIDE TREATMENT.DESPITE OF EXPLAINING ABOUT THE CONDITION AND RISK ASSOCIATED WITH CONDITION AND NEED FOR HEMODIALYSIS AND HOSPITAL STAY FOR FURTHER MANAGEMENT.PATIENT LEFT AGAINST MEDICAL ADVICE

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