Amoebic liver abscess
A 55 year old female R/o Miryalaguda, farmer by occupation came to OPD on 11 January 2022
C/o : stomach pain since 15 days
Hopi :
- patient was apparently asymptomatic 15 days back then she started experiencing stomach pain on the right side
- Insidious in onset, gradually progressive
- Pricking type of pain
- Associated with fever, motions and bloating sensation and pedal edema
- Bloating sensation since 20 days
- Fever - since 15 days with chills, reduced on medication
- Motions - 3-4 episodes per day, watery in consistentency, relieved after joining hospital
- Bilateral pedal edema since 15 days
- No similar complaints in the past
- No H/o diabetes, hypertension, epilepsy, heart disease, asthma.
- No H/o surgeries
- Diet : mixed
- Apetite : reduced
- Bowel : motions since 15 days
- Bladder : regular
- Sleep : adequate
- Addictions : occasional toddy drinker
- No Allergies
General examination :
- Patient is conscious coherent cooperative
- Moderate built, Moderate nourished
Pallor present
No signs of Icterus, cyanosis, clubbing, Lymphadenopathy, pedal edema
Vitals :
- Temperature : afebrile
- Pulse rate : 100 bpm
- Respiratory rate : 12 cpm
- Blood pressure : 120/80 mm of Hg
- Inspection :
- Shape of abdomen : distended
- Umbilicus. : inverted
- No scars, sinuses
- Palpation :
- Local rise of temperature : present in right hypochondrium and lumbar region
- Tenderness : present in the right hypochondrium and lumbar region
- Guarding : present
- Rigidity : present
- No fluid thrill
- Liver is enlarged
- Spleen : soft, non tender
- Auscultation : bowel sounds heard
- Normal vesicular breath sounds
- S1 and S 2 heard, no murmurs
- Sensory system : normal
- Motor system : normal
Diagnosis : amoebic liver abscess
Treatment :
- Pantop - i. v 40 mg OD
- Zofer - i. v 4 mg BD
- Metronidazole - 500 mg tid
- Inj ceftriaxone - 1 gm I. V BD
- Inj Tramadol - sos
- Intravenous fluids
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