CASE PRESENTATION

1. R.Anusha
Pharm D VI Year
Roll No:07

2.  Patient Name:Ms.PC
 Gender:Female
 Age:22 years
 IP No:290564
 DOA:15/9/19
 DOD:17/9/19

3. SUBJECTIVE
 Chief complaints : Complaint of burning micturition , fever
high grade , intermittent,associated with chills since 3 days,
abdominal pain since 4 days.
 Past illness history: Complaint of foul smelling urine since 1
month, history of similar complaints 2 months ago(burning
micturition and generalised body ache).

4. Lab investigations:
 CBC:WNL
 LFT:WNL
 Dengue NS 1 antigen -Ve
 Smear for MP -Ve
 CUE:8-10 pus cells
 Urine culture showed no growth
 USG abdomen: Mesenteric lymphadenopathy
FINAL DIAGNOSIS:
UTI with Mesenteric lymphadenopathy

5. OBJECTIVE
 Vitals
Pulse rate:101/min
Respiratory rate:16/min
Blood pressure:110/60 mm
Hg
Temperature:1010F
Pain score: 1/10(abdomen)
 Physical Appearance
Height : 168 cms
Weight : 56 kgs
BMI : 19.8 kg/m2

6. DRUG CHART
Drug Generic Dose Freq. ROA Category Indication
Inj.Specipime Cefepime +
Tazobactum
2.2 gm BD IV Antibiotic Emperic
therapy
IVF NS Normal
saline
100
ml/hr
STAT IV flow Electrolyte Hydration
Inj.Perfalgan Paracetamol 500
mg
QID IV Antipyretic Fever
Inj.Pan Pantoprazole 40 mg OD IV PPI APD
Tab.CIPLOX Ciprofloxacin 500
mg
BD PO Fluoro
quinolone
UTI
Inj.Hydrocort Hydrocortisone 100
mg
STAT IV Corticosteroid Allergic
reaction
Inj.Avil Pheniramine 1 ml STAT IV Anti allergic Allergic
reaction

7. ASSESSMENT
 Based on subjective and objective evidence, patient was
diagnosed as UTI with mesenteric lymphadenopathy.
 She was treated with IV Fluids , emperical antibiotic ,
antipyretics , antacids and other supportive drugs.
 IV Fluids Normal Saline 100ml/hr IV Flow was given for
fluid management.
 Inj.SPECIPIME (Cefepime+ Tazobactum)2.2 gram IV BD
was given as an emperic antibiotic.
 Cefepime is an antibiotic. Tazobactum is a beta-lactamase
inhibitor which blocks the action of enzymes produced by
bacteria to inactivate cefepime. Addition of Tazobactum
reduces resistance and enhances the activity of Cefepime
against bacteria.

8.  Patient had allergic reaction(developed itching and redness
over left upper limb) to inj.specipime.
 Doctor advised to stop Inj.Specipime.
 Inj.HYDROCORT(Hydrocortisone) 100 mg IV STAT and
Inj.AVIL(Pheniramine) 1ml IV STAT was given for allergic
reaction to Inj.Specipime.
 Inj.Perfalgan(Paracetamol) 500 mg IV QID was given for
fever.
 Inj.Pan(Pantoprazole) 40 mg IV OD was give for APD.

9.  Tab.CIPLOX(Ciprofloxacin) 500 mg PO BD was given for
UTI.
 The bactericidal action of ciprofloxacin results from
inhibition of the enzymes topoisomerase II (DNA gyrase)
and topoisomerase IV (both Type II topoisomerases), which
are required for bacterial DNA replication, transcription,
repair, and recombination.
 Symptoms resolved.
 Ultrasonogram abdomen showed mesenteric
lymphadenopathy.
 But patient not willing for further evaluation.
 Hence patient is being discharged at request.

10. PLAN
Monitoring parameters
Watch for hypotension , tachycardia,
 Watch for increase in fever spikes , SOB , drop in SpO2
Advised gynaecology opinion to rule out Pelvic
inflammatory disease(PID).

11. DISCHARGE MEDICATION
T.CIPLOX 500mg 1 tab to be taken orally twice daily after
food for 5 days(UTI)
T.PAN 40 mg 1 tab to be taken orally before breakfast for 5
days (APD)
T.ZINCOVIT 1 tab to be taken orally once daily after food
for 10 days (MVT)
Follow up instructions :
Review after 5 days in OPD with CBC.