28 year old female with fever and headache
Chief complaints:
●H/o of fever since 4 days
● H/O of headache since 3 days
● H/o of nausea since three days
●H/o of bodypain since three days
History of present illness:
● patient was apparantly asymptomatic 14 days back then she developed fever after taking her covid vaccine associated with vomitings for 2 days .she took medication from local RMP and fever subsided.
● C/o fever which is continuous type and associated with chills and rigors with retroorbital pain since 3 days .
● C/o headache diffuse type associated with nausea.
● H/o vomitings since 3 days which is non bilious and non rejectable.
History of past illness:
History of hair loss since 3 years and weight loss since 3 years
● No h/o diabetes, hypertension, asthma,Tb,
● No h/o blood transfusion ,surgeries
● No h/o chemo and radiation
●No hormones or antibiotics used.
PERSONAL HISTORY:
* Married and house wife
* appetite _ lost
* bowel is regular
* micturation is normal
* nonvegeterian
* no known allergies
* non alcoholic and non smoker
Physical examination:
No cyanosis, no pallor,no edema and no clubbing and no dehydration and well nourished
* on examination of neck multiple cervical lymphadenopathy.
* enlargement of thyroid.
Menstrual history:
Menorrhagia with small clots using 3 pads per day.
White discharge 3 days with foul smell.
Investigations:
* Hb 6.6
* RBC ..anisopikilocytosis with hypochromia with microcytes ,tear drop cells and pencil forms.
* WBC reduced on smear
* Impression : Microcytic hypochromic anemia with leukopenia.
* FERRITIN : 5.5
Diagnosis: Acute thyroiditis with cervical lymphadenopathy secondary to menorrhagia
Iron deficiency anemia/ microcytic hypochromic anemia.
Treatment. ...
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