17 year old female with fever and generalized weakness

A VISHAL
1701006001
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 with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box

Our 17 yr old female patient came to the casuality with the chief complaints of 
1.Fever since 3 days
2.Generalised weakness & dragging type of pain of lower limb Since 3 days.
HOPI:-
Patient was Apparently asymptomatic 3 days back .Then she developed fever which is high grade not associated with chills&rigors and fever is continuousl ,relieved on taking medication.she  developed generalised weakness &dragging type of pain of both lower limbs .
No H/o SOB, Palpitations,Chestpain.
No h/o Pain Abdomen, Vomitings, Loose stools.
No h/o cough,cold.
No burning Micturition/ Hematuria.
No h/o Giddiness 
No h/o Blood in stools & Dark colured stools.
PAST HISTORY:-
Not a known case of HTN,DM,Thyroid,epilepsy,CAD
EXAMINATION:-
Patient was conscious coherent cooperative
No pallor ,cyanosis, lymphadenopathy, pedal edema, clubbing.
Temp- 98.6 f
PR- 70 bpm
RR- 14 cpm
BP- 120/70mm hg
CVS-s1 S2 +
CNS - NAD
P/A- soft ,nontender.
R/S- BAE+
DIAGNOSIS:-
VIRAL PYREXIA WITH THROMBOCYTOPENIA
INVESTIGATIONS:-
TREATMENT:-
1)IV fluids 1unit NS,1 unit RL@100ML/hr
2)INJ NEOMOL 1gm /IV/sos
3)INJ.PAN 40 mg IV/OD
4).INJ.ZOFER 4 mg/IV/SOS
5)TAB.PCM 650 mg po/TID.

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