MEICAL WARD 34 DISCUSSION OF DENGUE DEATH

MEICAL WARD 34DISCUSSION OF DENGUE DEATHMr. Sarjun, 29yrs old male transferred from BH. Kattankudy with the history of fever, vomitting and loose stool for 3days.In LH- BP -80/60, tachypnoeaManagement given there- 1pint RL -IV maxalon 10mg -IV ranitidine 50mg -IV ciproflox 400mgIn ETU the history revealed, fever for 3daysRight HC pain and loose stool since the day of admissionPMHX- NADPSHX NADSocial history smoker and alcoholic he is a fisherman, the day before admission he went to sea On exa ill looking/ febrile/ tachycardia/ lungs-clear abd-RHC tenderness, with good hydrationInvestigationECG sinus tachycardiaFBC WBC-1300; N-52.7;L-42.9 HB -13.1; PCV -40.3 PLT -14000CRP -116mg/dl ESR -04LFT AST -58IU/L ALT -44IU/L Slightly raisedRFT BU- 23mg/dl SC -1.5mg/dlUSS abd and chest mild to moderate pleural effusion more in right side. Pericolic collection an minimal free fluid. Early CRF changes. Prominent intra hepatic ductCXR atypical pneumonia , reported by CRManagement given in ETU QHT Oxygen via FM PCM 1g stat IV omeprazole 20mg stat IV maxalon 10mg stat IV morphine 2.5 mg stat IV ciproflox 500mg stat Patient sent for CXR, after CXR he came to ETU and he got dyspneoc, tachypneoc, saturation reducedVP over the phone informed, he came to see the patient, IV frusemide 40mg stat givenPatient condition got worsenIntu bated and resusitation done Patient transferred to ICU as ECG shows asystoleIn ICU after 45min of resusitation patient diedInquest requested by VP.