Viral pneumonia

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A 60 yr old male farmer by occupation, resident of narketpally came to the casuality 

with chief complaints of dry cough, sob since 3 days and fever since 1 day.


Hopi: patient was apparently asymtomatic 3days back then he had dry cough, progressive in nature not associated with any diurnal/ postural variation.

sob initially grade -II gradually progressed to grade-IV. 
not associated with any PND,orthopnea, pedal edema.
from day 1 patient is having fever, low grade, intermittent, not associated with chills and rigors, relieves on taking medication.

No h/o any decreased urine output.


Past history: 
no H/o of diabetes hypertension,asthma,TB, epilepsy

Genral examination:
pt is c/c/c, 
afebrile.
BP-140/80, 
pr-104, 
sats-89(at 15L of o2)

Diagnosis: Viral pneumonia with type 1 respiratory failure with AKI

Clinical pictures:-






Treatment:-

1. O2 inhalation to maintain spO2 >92%
2. IVF NS, RL @75 mL/ hr
3. Inj. ceftriaxone 1gm iv/bd
4. Tab. AZITHROMYCIN 500 mg po/od
5. Inj. Pan 40 mg iv /od
6. Inj thiamine 1 ampoule in 100 ml ns iv/bd
7. Nebulisation with duolin 12th hrly, budecort 8th hrly 
8. Inj LASIX 20 mg iv/bd
9. Tab. Atoz po/od
10. Strict i/o charting
11. Temp charting 4th hrly 
12. Intermittent BiPAP for 30 min every 6th hrly

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