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title: AyePages Editor 3 date: T15:34:30 +05:30 categories:

blog
intro tags:
demo
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title: AyePages Editor date: T15:34:30 +05:30 categories:

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intro tags:
demo
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title: AyePages Editor date: T15:34:30 +05:30 categories:

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intro tags:
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Acute Kidney Injury secondary to Urosepsis

June 19, 2021 A 60yr old female presented to the OPD with chief complaints of pedal edema since 10 days, decreased urine output since 10 days and fever since 10 days. History of present illness: The patient was apparently asymptomatic 5 years back following which she was diagnosed with DM2 on checkup and on Teneligliptin 20 mg. In 2019 ( 2 years ago) she developed fever, shortness of breath and pedal edema and diagnosed with Acute kidney injury secondary to urosepsis and resolved conservatively after dialysis (4 sessions) Now presented with history of fever, high grade since 10 days, not associated with vomiting and loose stools . Patient complaints pedal edema bilateral and pitting type, with decreased urine output and burning micturition. History of past illness: Outside reports suggest acute kidney injury. Known case of diabetes mellitus since 10 years and on tab Teneligliptin 20 mg and not known case of hypertension, bronchial asthma, tuberculosis. Personal history:

Married
Mixed diet
Noamal Appetite
Adequate sleep
Bowel movement is regular
Decreased urine output and burning micturition
With no known allergies.
Consumes alcohol occasionally.

Family history: No significant family history General examination:

There is Pallor
There is no Icterus, cyanosis, clubbing
Generalized Lymphadenopathy
Edema is seen bilaterally witch is Pitting type pedal edema.

Vitals:

Temperature afebrile
Pulse rate is 111 beats per minute
Respiratory rate is 16 breaths per minute
Blood pressure measured on the left hand is 170/110 mm of Hg
Oxygen saturation at room air is 90 arm per mm Hg

Systemic examination: Abdominal system:

No scars, sinuses, or any engorged veins.
Hernial orifices intact
Tenderness or guarding absent
No enlargement of liver, kidneys, or spleen
No ascites
Bowel sounds were normal.

Cardiovascular system:

cardiac sounds s1 and s2 heard normally
Apex beat located in 5th ICS, medial to the mid-clavicular line.
No cardiac murmurs
Thrills absent

Respiratory system:

No chest wall deformity
Trachea central
Expansion is symmetrical
Percussion note is resonant
Breath sounds normal, no wheeze or crackles heard.
Vocal resonance normal and symmetrical

Musculoskeletal system:

Gait normal
No muscle or soft tissue changes.
No bone or joint deformities.
No limitation of movements.

Central nervous system:

No focal abnormality detected
Higher mental functions intact
Cranial nerves I- XII: No cranial nerve abnormality detected.
Speech normal

Provisional diagnosis:

Acute kidney injury secondary to urosepsis

Investigations ordered: 14/06/21

Complete urine examination:
1. ECG:
**15/06/21:**1. Serum creatinine: 2. Blood sugar Fasting: 3. Blood sugar Random: 4. Blood Urea: 5. Serum Electrolytes: 6. Serum Potassium: 7. Urinary Chloride: 8. Urinary Potassium: 9. Urinary Sodium: 16/06/211. Serum Electrolytes: 2. Serum Creatinine: 3. Haemogram: 4. Blood urea: 5. ABG: 18/6/211. Serum creatinine: 2. Serum Electrolytes: 3.Haemogram: 4.Blood urea: 21/6/211. Complete Blood Picture (CBP) Blood urea: 15/6/21 - 65 mg/dl16/6/21 - 62 mg/dl18/6/21 - 76 mg/dl21/6/21 - 81mg/dl Serum creatinine: 15/6/21 - 3.4 mg/dl16/6/21 - 3.4 mg/dl18/6/21 - 3.2 mg/dl21/6/21 - 3.1 mg/dl Total leukocytes count: 16/6/21 - 2470018/6/21 - 2650021/6/21 - 31700 Serum Electrolytes: 15/6/21 - Na: 139 ; K: 5.2 ; Cl: 10616/6/21 - Na: 138 ; K: 5.1 ; Cl: 10518/6/21 - Na: 136 ; K: 4.9 ; Cl: 10221/6/21 - Na: 134 ; K: 5.5 ; Cl: 98 Diagnosis: Acute kidney injury secondary to urosepsis with hyperkalemia ( resolved)With anenmia of chronic disease Treatment: 15/06/21: Treatment: