60 old year female with high grade fever,genelarized weakness since 3 days

I am presemting a case of 60 year old female, house wife resident of addaguduru, came to opd with
Chief complaints:
High grade fever since  6 days, not associated with chills and rigor, complaints of weekness since 2 days. 
History of present illness:
Patient was apparently asymptomatic 5 days back and then she developed fever  high grade , continuous not associated with chills and rigor 
C/o generalized weakness since one day, urinary incontinence, 
So they went to local hospital and got to know that she is having thypoid and increased sugar levels in the body , so they have brought her to kamineni
No c/o nausea , vomitings , no abdominal pain, 
No loose stools no cough cold
Past history:
 known case of dm type 2 since 10 years 
Previously using glimeperide 2 mg,metformin 500 mg
Since thursday glimiperide 1 mg , metformin 500 mg
Not a known case of HTN, CVA,CAD, epilepsy, bleeding diaorder. 
Patient has h/o diabetic retinopathy since 5 years. 
PERSONAL HISTORY: 
Diet - Mixed 
Appetite - Normal 
Sleep -Adequate
No addictions 
No Drug or food allergies. 
Since 2 days decreased appetite
B/b : irregular, constipation+

Family history 
Insignificant. 
GENERAL EXAMINATION
28/8/23
patient is conscious,not coherent, cooperative

 Pallor present

 No Icterus 

No Pedal oedema 

No cyanosis 

No clubbing 

No koilonychia 

No lymphadenopathy

 JVP - Raised 

Bp:110/70 mmhg
Pr : 79 bpm
Rr: 16 cpm
Grbs 520 mg/dl @ 1ml/hr inj HAI
SPO2:98%
Cvs : s1s2 heard no murmurs
Rs : b/l ae+.
P/A: soft non tender
CNS:no findings
Investigations 
28/08/23



30/08/23
31/08/23
PROVISIONAL DIAGNOSIS:
High grade fever

Treatment history:
28/08/23:
Iv fluids NS @100ml/hr
INJ HAI 1 ml +39 ml NS @1 ml/hr
RT feeds water 2nd hourly
BP, RR, PR 2nd hourly
INJ- MONOCEF 1gm IV /BD
31/08/23:
Iv fluids NS @100ml/hr
INJ MONOCEF 1 gm IV /BD 
INJ HAI 1 ml +39 ml NS @1 ml/hr
RT feeds water 2nd hourly
BP, RR, PR 2nd hourly

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