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T A Krishnan Kutty,52yrs/M C/o C S Menon 12/11/11

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Provisional Diagnosis - Ac Pyelonephritis Lt ?Ac choletcystitis To r/o Renal Tuberculosis
Final Diagnosis - Ac Pyelonephritis Lt Urine AFB culture automated-Pending
History and Findings - Case worked up at GVR Sat clinic on 12/11/11 & later investigated in AIMS H/o Fever around 101*F since 4months,one episode of hematuria.LUTS+,h/o br asthma since 7yrs on inhalers,K/c/o SHTN on Amlodipine 5mg od. past PTB 1988 fully Rxd. Exam revealed tenderness Lt kidney on ballotable test
Investigation - ESR-120,Hb-11.6,CRP-23,Urine ACR-1816mg/g,BU-25mg,S.creat-1.27,LFT/GGT-N,Urine Alb +,Gr cast + Dengue IgM & Brucella IgM neg,ANA-Neg,C-ANCA,P-ANCA Neg,PSA-1.1,S.Protein EP-Neg,IgG-1650,IgA-516,IgM-101,Urine BJ protein Neg,IVU study-consistent spasm upper pole calyx Lt kidney clubbed calyx,DMSA scan on 12/12/11-No e/o any cortical scar B/l kidneys to suggest chronic Pylelonephritis,HIDA scan 13/12/11-Preserved hepatobiliary function,no e/o acute/chronic cholecystitis.ECG-Wnl,Cxr-Increased BVm Rt base,urine culture no growth,blood culture-no growth,widal-Neg,MP MF Neg,USG abd-Cholelithiasis,multiple stones largest 6.4mm,fatty liver,Mantoux-Neg,urine AFB culture-pending,urine cytology-Neg,Xray L S spine-spondylitis
Treatment - .Zanocin OD 400mg 0-0-1 x 6wks,Tab.Dolo 650mg 1sos,Ct Foracort Inh & Amlodipine as before
Follow Up - Pt afebrile 2 wks after starting antibiotics 12/12/11 ESR-60 started attending daily office work R/w with urine AFB culture
Last modified on Thursday, 29 December 2011 07:54
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