47 year old female with SOB, Urticaria and extrampulmonary TB

September 05, 2022

47 year old female with SOB, Urticaria and extrampulmonary TB

Note: This is an online E Log book recorded to discuss and comprehend our patient's de-identified health data shared, AFTER taking his/her/guardian's signed informed consent.

Here, in this series of blogs, we discuss our various patients' problems through series of inputs from available global online community of experts with an aim to solve those patients' clinical problems, with collective current best evidence based inputs.

This E-log book also reflects my patient-centered online learning portfolio and of course, your valuable inputs and feedbacks are most welcome through the comments box provided at the very end.

I have been given the following case to solve, in an attempt to understand the concept of "Patient clinical analysis data" to develop my own competence in reading and comprehending clinical data, including Clinical history, Clinical findings, Investigations and come up with the most compatible diagnosis and treatment plan tailored exclusively for the patient in question.

PRESENTING COMPLAINTS:

Generalized Itching since a month.

Shortness of breath since 10 days.

Abdominal pain since 7 days.

Lower back pain since 7 days.

HOPI:

She is a known case of Extrapulmonary tuberculosis with Ascites. She has been taking treatment since (ATT)21/07/2022. Now she came to the OPD with complaints of Itching all over her body since 7- 10 days after starting the ATT regimen. There is gradual increase in size of abdomen. She complains of back pain since 1 week.

PAST ILLNESS:

6 years back Patient was giddy and went to a local hospital where she was diagnosed with diabetes mellitus. She took oral hypoglycemics and was later shifted to insulin after 4 years. 5 months ago she had complaints of pedal edema, she sought for consultation at a local hospital and got discharged after reduction in pedal edema. Now patient complains of shotness of breath even while dressing and sitting and gradual abdominal distension. Ascitic tap was done and reports were found to be Low SAAG Low protein. She was diagnosed with HTN and Hypothyroidism.

Enlarged cervical lymph nodes were present and USG NECK was ordered it showed which showed B/L discrete lymphnodes at level I B/ II/ III/ IV.