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 Fwith an aim to solve those patient's clinical problems with collective current best evidence based inputs. 


CHIEF COMPLAINTS
                - Fever since 10 days
                - Loose stools since 5 days
                - Pain abdomen since 5 days
HOPI
Patient was apparently asymptomatic 10 days ago then he developed fever high grade ,continuous associated with chills and rigor relieved on medication,no nausea ,no vomitings, no burning micturition.Loose stools since 5 days , 3 episodes per day very small volume liquid in consistency no blood stools,no pus in stools,non foul smelling .Pain abdomen present diffuse type relieved on passing stools

PAST HISTORY 
N/k/c/o DM,HTN,Asthma,TB ,Epilepsy

FAMILY HISTORY 
NO relavent family history

PERSONAL HISTORY 

Diet:Mixed type
Appetite: Normal 
Micturition: Normal
Bowel and Bladder movements: Normal
Sleep: adequate 
Addictions: 
Consumes Alcohol 90 ml per day since 40 yrs
Consumes bd from 40 yrs of age 3-4 per day 
  
GENERAL EXAMINATION
No Sign of Pallor,Icterus,cyanosis,clubbing,Lymphadenopathy,oedema

VITALS
Temp: Afebrile
Pulse rate:120bpm
Respiratory rate: 20/ min
BP: 120/80 mm Hg
SpO2: 96%

SYSTEMIC EXAMINATION 

C V S : SI and S2 Heard
No murmurs

Respiratory system:
BAE+ ,
Normal vesicular breath sounds heard

Per abdomen: soft and nontender 

Non palpable no organomegaly.

Normal Reflexes 
 CNS: Normal
 

PROVISIONAL DIAGNOSIS
AMOEBIC LIVER ABSCESS
INVESTIGATIONS 

TREATMENT
1. Inj Metronidazole 500 mg iv tid
2.Inj.Optineuron 1 ampoule in 100 ml NS iv OD
3.Inj Thiamine in 100 ml NS iv BD
4.Inj. Neomol 1 gm SOS
5. Inj. pantop iv OD 
6. Tab PCM 650 mg PO  SOS
7. Vitals monitoring 
8. Inj. PIPTAZ TID 

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