IDENTIFYING PROFILE

NAME: Mrs.Quinn Cyra Cabiaro SEX: female

AGE:29 CIVIL STATUS: married
ADDRESS: Davao city RELIGION: Catholic
OCCUPATION: Bank employee

CHIEF COMPLAINT: Abdominal pain

HISTORY OF PRESENT ILLNESS:

5 days PTA, patient noted to have body malaise on a pain scale of 10/10, worsening like
she cant move, associated with fever, headache and nausea, self medicated with bioflu one
tablet mild relieve with the fever,persistence of body malaise and headache, no consultation
was done.
3 days PTA, on and off fever, patient feeling hot with body malaise, did not note the
temperature, still associated with nausea and headache, started taking paracetamol, but no
relief, no consultation was done.
2 days PTA, no fever, patient noted to have squeezing abdominal pain on a pain scale of
7/10, non radiating in character, relieved by taking food and when she was lying down, but
got worsen when she trying to sleep later recumbent position.she self medicated with
omeprazole one tab, no relief, this prompted her to take consultation in a private clinic.
On the day of admission, no fever, she started to have shortness of breath associated
with abdominal pain and she noticed rashes on her hand and her leg,which was like small
papules, non itching in character, this prompted the patient to take consultation in San
Pedro Hospital.

PAST MEDICAL HISTORY:

Chicken pox +, no measles, no mumps
No hypertension, no diabetes, no asthma
In 2013, she got diagnosed with dengue and hospitalized
No major or minor surgeries done before
LMP last month, regular
Not taking any contraception pills
Immunized until now, took 2 doses of synovac, no booster dose
No allergy to any medication

FAMILY HISTORY:
Father diabetes +,controlled
5 sibilings
No history of cancer
No history of heredofamilial diseases
No history of hypertension
No history of coronary artery diseases

PERSONAL AND SOCIAL HISTORY:

Works in a bank
Married and have two children
No exercise but last month she was in diet (no carbohydrates)
Occasional drinker, 2-3 bottle of beers per sitting
Non smoker
No illicit drug use
 REVIEW OF SYSTEMS:
General: has loosed 1kg in past 5 days
Skin: rashes in hand and leg +, no discoloration
Head: headache +, no lumps
Eyes: no cataract, no glaucoma
Ears : no discharge
Nose and sinus: runny nose +
Mouth and throat: no sore throat and infection
Neck: no lumps and no masses
Respiratory : shortness of breath +, no cough
Cardiovascular: dyspnea +, no chest pain
Gastrointestinal: abdominal pain+, nausea +, no vomiting,
Urinary: more frequency +, no dysuria
Genital: no vaginal infection
Peripheral vascular: no varicose vein, no edema
Musculoskeletal : body malaise +, back pain +, no joint pain
Neurologic : no fainting, no seizures
Hematologic: no bleeding gums
Endocrine: sweating average +, fever on and off
Psychiatric : no delusion, no depression

PHYSICAL EXAMINATION:
Vitals : HR: 75, BP: 110/80, RR: 18, TEMP: 36, O2 sat: 96%
Patient awake,conscious, not in distress, well oriented
Rashes on hand and leg +, not in trunk, small papules not itching in character
Hermann’s sign + (rash , petechial)
Abdominal tenderness epigastric region +
No liver enlargement
No lymphadenopathy
No gum bleeding
No signs of hemorrhage
No seizures
Signs of polyuria
Clear heart sounds
Body malaise+

IMPRESSION:
Dengue fever without warning signs

DIFFERENTIAL DIAGNOSIS : fever, body malaise, rashes, headache,nausea, abdominal pain

MALARIA : Rule out, no parasitic infection, no travel to malaria endemic region
TYPHOID FEVER : Rule out, no street food consumption, no stepwise fever, no loss of
appetite, no diarrhea
COVID 19: Rule out, no loss of taste,
CHIKUNGUNYA FEVER: rule out, no rashes on trunk, no periarticular edema or swelling, no
peripheral lympadenopathy
RUBELLA: rule out, no koplik spots
ZIKA VIRUS DISEASE:

SUMMARY:
A 29 yr old women,bank employee presented with 5 days history of abdominal pain
associated with on and off fever, severe body malaise, rashes on hand and legs, shortness of
breath, headache and nausea. No alteration in mental status, she was well oriented,
suggestive of dengue fever without warning sign
 DISCUSSION :
SALIENT FEATURES:
 29/ female, bank employee
 Occasional drinker and non smoker
 Epigastric pain
 Shortness of breath
 Rashes on hand and legs
 Hermann’s sign + (rash , petechial
 Fever on and off, nausea and headache
 Severe body malaise
 No co-morbidity
 Previous history of dengue in 2013, hospitalized
 Normal vitals
 Polyuria

Dengue fever
Dengue (break-bone fever) is a viral infection that spreads from mosquitoes to people. It is
more common in tropical and subtropical climates.
Most people who get dengue won’t have symptoms. But for those that do, the most
common symptoms are high fever, headache, body aches, nausea and rash.
Symptoms occur, they usually begin 4–10 days after infection and last for 2–7 days
Common sympotoms of dengue :
 severe abdominal pain
 persistent vomiting
 rapid breathing
 bleeding gums or nose
 fatigue
 restlessness
 blood in vomit or stool
 being very thirsty
 pale and cold skin
 feeling weak.

3 phases: Febrile, Critical and Recovery phases