Authors: Anne Creaton, Vishal Narayan / Editor: Anne Creaton, Vishal Narayan / Reviewer: John Wilson, Ines Corcuera / Codes: / Published: 01/11/2023
A 26-year-old Indian male presented to Emergency Department (ED) after being unwell for 5 days. He had generalized body weakness, fever and headache. In the last two days he had developed loose bowel motions and non-productive cough with dyspnoea. He had 7 episodes of loose stools and with no blood in the stool. In addition he had chills, rigors and calf pain.
He denied any vomiting; chest, abdominal or backache.
On the first day of illness he had been seen by a general practitioner and prescribed paracetamol.
He is a baker by profession and enjoys smoking, drinking kava and alcohol.
On examination he was not in any obvious respiratory distress but appeared unwell. His initial vital signs were BP 96/37, HR 119, temp 39.3, RR 26, Spo2 99% in room air and GCS 15/15. He had no jaundice, pallor, his chest was clear and abdominal exam was unremarkable. There was no rash but he had significant calf tenderness.
He was assessed as acute febrile illness and prescribed paratcetamol 1g and placed on 8 hourly normal saline infusion.