Hi Doctor,
My father has been hospitalized with following history :
SATURDAY MORNING (30th of march 2013) :Complains by Patient:-
Restlessness and sleep loss from past 3-4 days, burning sensation in urination pain and stretch in muscles and bones, nervousness, problem in exhaling.
Went to Dr. Binay Prasad
X-ray and blood test prescribed. (Refer to attachment 1)
Through the WBC count (31,200) and X-ray the docter diagnosed chest infection.
Medicines prescribed are as follows:-
1.     Monocef 1g( Ceftrixone) – IV BD
2.      Amixide H – Bed time
3.      Trinicalm plus – 2 times a day half tablet
After 1st doze of medicine from Saturday evening vomiting problem started.
SUNDAY (31st of March 2013)
The patient vomits on any food or water intake.
Docter prescribes:-
1.     Ondum
2.     Rest continued.
Vomit doesn’t stops after 2 dozes of ondum, instead some blood trace along with sputum is noticed. The concerned docter prescribes to admit in I.C.U, emergency ward, PMCH, Patna.
SUNDAY NIGHT(31st of March 2013)
Patient is admitted to Arvind Nursing Home, Patna.
Medicines prescribed as per previous report and complains by Dr. P.K. Suman are as follows:-
•     1. Piperacillin Sodium and Tazobactam Sodium Injection 4.5 gm IV BD
•     2. Perinorm (Metoclopramide Hydrochloride) 2ml.
•     5. Saline Drip (Sodium Chloride (.9%) with Dextrose Injection (5%)
•     6. Levofloxacin Infusion 500mg (100ml).
•     7. Budecort .5mg (2.5ml)(Budesonide Respirator Suspension). – for inhalation only.
•     8. Duolin 2.5 ml (Levosalbutamol and ipratropium Bromide Respirator Solution.
•     9. Alkasol syrup. 3 times a day.
•     10. Urispas. 3 times a day.
•     11. Urimax. 1 at night time.
Report of test prescribed by doctor: - (Refer to attachment 2).
TUESDAY (2ND OF APRIL 2013): Patient started feeling better. No sign of any weekness and started doing all his routine activity.
Docter prescribes ultrasound. (for report Refer to attachment 3)
Medicine continued till Thursday.
Only duolin & budecort stopped after no complain of breathing by patient.
For nausea, he is prescribed nausivion drops.
THURSDAY & FRIDAY (4TH & 5th OF APRIL 2013)
Docter prescribes 1 more test on Thursday (4th of april) (Refer to attachment 4).
To clear up doubt of leukaemia because of not decreasing WBC count docter takes up 2 test( TC DC and Peripheral smear) (for report Refer to attachment 5).
SATURDAY (6TH OF APRIL 2013)
Docter diagnosed the patient’s condition may be as sepsis.
Takes few more test. ( for reports refer to attachment 6).
Medicines changed from Saturday night.
Medicines prescribed are as follows:-
1.     Meropenem Injection (1g). IV TDS
2.     Pazufloxacin mesylate I.V Infusion (500mg) IV BD.
3.     Clindamycin Injection USP – 600mg. IV TDS.
4.     Entrogermina – 10.
5.      Lonazep.
6.      Alkasol syrup. 3 times a day.
7.      Urispas. 3 times a day.
8.     Urimax. 1 at night time.
Now from past 5 days patient is normal and able to do all his activities, eating properly. There is no complain
What could be reason of high w.b.c count (40,000) ?
Do any further diagnosis need to do ?