14 Yr male with b/l neck swelling



 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box

A.Nikhil 

1701006013

 A 14 yr old male regular school going student resident of narketpally presented to opd with 

chief complaints of pain below ear  and neck swelling since 2 day facial swelling since 1 day

HISTORY OF PRESENTING ILLNESS-

Patients was apparently asymptomatic 2 days back. Then he  experienced pain below the ear which was pricking type and aggravated on eating and he developed fever which is sudden in onset for which He took (Amoxycillin and paracetamol) at home and the fever and pain subsided. 

But on the next day there was bilateral facial swelling and pain was present which was tender on touch. 

There is no itching, rashes, nasal congestion, burning micturation, shortness of breath. 

No nausea ,vomiting.


PAST HISTORY-


There is no history of HTN, DM, Asthma, leprosy, ckd. 

He had covid on 7th May 2021 and he is non vaccinated. 

He had dengue in October 2021.

He had similar complaints in the march 

PERSONAL HISTORY-

Diet - Mixed

Appetite - Normal

Bladder and bowel - Regular

Sleep - Adequate

Allergies - None. 


FAMILY HISTORY - 

His brother had similar complaints 


GENERAL EXAMINATION-

Patient is conscious coherent and co operative well oriented to time place and person. 

Patient was examined in a well lit room and consent was taken.

Vitals -

PR-78 bpm

BP-110/70

RR-16cpm

SPo2-98%

Temp-Afebrile

Pallor - Absent



Icterus - absent

Clubbing - Absent

Cyanosis- Absent

Lymphadenopathy- Present ( cervical b/l) 

Edema - Absent








SYSTEMIC EXAMINATION-

CVS - S1, S2 heard

Resp - NVBS

CNS - NAD

Per Abdomen - Soft and non tender

INVESTIGATIONS

Haemogram


RFT-

CUE-


LFT-



USG:-NECK


USG:- ABDOMEN 

ECG-


2D echo-



Provisional diagnosis

CERVICAL LYMPHADENOPATHY SECONDARY TO ? UPPER RESPIRATORY TRACT INFECTION  ? Viral

 
TREATMENT:- 

1) DOXYCYCLINE- 100 MG/BD
 
2)  DOLO 650 TID 

3)  IV fluids 
 
Monitor vitals  inform sos

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