I'm a consultant Physician from India treating a difficult fever
fever with chills, dry cough, giddiness and fatigue
Pt has acne over the forehead(no discoid rash)
Liver and spleen are both palpable
Liver 2 cm, soft
Spleen 3cm, firm
Investigations as under
TLC 4000 P69L30E1 MP negative
Initially urine showed 15-20RBCs and 8-10 pus cells/HPF
subsequently WNL after antibiotics
HIV, HBSAg negative
USG showed 4.7mm renal calculus in Rt kidney with hydronephrosis, hydroureter(mild)
Inj Ofloxacin 200mg IV bdfor 7 days (28/11 to 4/12)
Inj Gentamicin 60mg IV bd for 7 days(28/11 TO 4/12)
Inj artesunate full course given (2/12 TO 6/12)
Inj Piperacillin Tazobactam has now been started since 4/12/08 she still has fever
following is her fever chart
2/12 6am 102
3/12 7am 102
4/12 2am 100
4/12 8pm 102
5/12 3pm 102
6/12 6am 102
Any senior physicians please help
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