Dr.Keerthi Madireddy

40 M CAME TO PULMONOLOGY OPD WITH CHIEF COMPLAINTS: C/O COUGH (DRY) :1 WEEK C/O :FEVER: 7DAYSHOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 1 MONTH BACK, LATER HE DEVELOPED INITIALLY COUGH WITH SPUTUM LATER NON PRODUCTIVE COUGH FOR WHICH HE GOT ADMITTED AND DIAGNOSED AS LEFT PLEURAL EFFUSION.NOW PRESENTLY WITH DRY COUGH SINCE 1 WEEK ,MORE IN THE NIGHT.NO AGGRAVATING AND RELIEVING FACTORS. FEVER SINCE 1 WEEK,LOW GRADE EVENING RAISE PRESENT, SUBSIDED WITH MEDICATION. NO COMPLAINTS OF CHEST PAIN, DECREASED URINE OUTPUT, SWEATING, PALPITATIONS. H/O SIMILAR COMPLAINTS IN THE PAST FOR WHICH DIAGNOSED AS LEFT PLEURAL EFFUSION (TAP DONE 1500ML ON 23/3/23AND 25/3/23 AND SENT FOR PLEURAL FLUID ANALYSIS. TC-5400,DC-100%L, PLEURAL FLUID ADA -41 IU/L, PLEURAL SUGAR - 211MG/DL, PROTIENS-5.4G/DL NO H/O USAGE OF INHALERS IN PAST NO ALLERGIC H/O K/C/O DM ON GLIMESTER M1 FORTE BD 7YEARS N/K/C/O HTN, THYROID,CAD. SMOKER FOR 5 YEARS(1 BEED PER DAY)STOPPED SMOKING FOR 2 YEARS TOBACCO CHEWING 3 YEAR

 PATIENT CAME WITH COMPLAINS OF COUGH WITH SPUTUM SINCE 15 DAYS,FEVER SINCE 15 DAYS , SHORTNESS OF BREATH SINCE 2 DAYS  HISTORY OF PRESENTING ILLNESS  PATIENT WAS APPARENTLY ASYMPTOMATIC 15 DAYS BACK , THEN SHE DEVELOPED COUGH WITH SPUTUM SINCE 15 DAYS WHICH IS WHITISH,MUCOID,NON FOUL SMELLING , NON BLOOD STAINED , NO AGGREVATING AND RELIEVING FACTORS . C/O FEVER SINCE 15 DAYS ,EVENING RISE OF TEMPERATURE ,LOW GRADE NOT ASSOCIATED WITH CHILLS. C/O SHORTNESS OF BREATH SINCE 2 DAYS , GRADE 3 MMRC , NO WHEEZE , AGGREVATED ON EXCERTION , NO RELIEVING FACTORS. NO ORTHOPNEA, NO PND . C/O LOSS OF APPETITE , C/O LOSS OF WEIGHT 5KG IN 1MONTH. C/O CHEST PAIN ON RIGHT SIDE SINCE 2DAYS,NON RADIATING. BIOMASS EXPOSURE PRESENT SINCE 30YEARS.  PAST HISTORY  NO H/O SIMILAR COMPLAINTS IN PAST  NO H/O TB IN PAST,NO INHALER USAGE NOT K/C/O DM,HTN,CAD,EPILEPSY,HYPOTHYRODISM  PERSONAL HISTORY  WEIGHT:60 KG  OCCUPATION : HOUSEWIFE NON SMOKER BETEL LEAF CONSUMPTION OCCASIONALLY.   FAMILY HISTORY : NOT SIGNIF