Orchitis-Case Study

Orchitis-Case Study

1. Case Presentation on Orchitis

2. Name : Mr. X Age : 54 years DOA : 24/10/13 Sex : Male Weight : 60kg Chief Complaints: C/O Severe testicular pain radiating to the abdomen C/O vomitting . History of Present I llness : H/O left abdominal pain H/O decreased appetite Past Medical H istory : K/C/O DM 15 Years

3. Past Medication H istory : Metformin-500mg,glimepiride-1mg, Underwent surgery for right inguinal hernia since 5 years before Social History : Non-Smoker, non-alcoholic, married Physical Examination: Patient is conscious/ oriented. No Pallor, cyanosis, clubbing. Normal lymph nodes. On Examination : Temp: Afebrile B.P: 120/80mmHg Pulse: 80/min System Examination: CVS: S1S2+, RS: NVBS CNS: NFND P/A: Soft, Painful

4. LAB INVESTIGATIONS PARAMETER OBSERVED VALUE NORMAL RANGE Hemoglobin 14.8g/dl 14-18g/dl RBC 4.7millions/mm 3 4.5-5.6million/mm 3 ESR 21mm 5-15mm PCV 47% 45% DC N -85% L- 35% E-2% N-40-75% L-30-50% E-2-6% Total WBC 13500 cells/mm 3 4000-11000 cells/mm 3 MCV 91.6 80-96fl/red cells MCH 30.2 26-33pg/cells MCHC 33 31-36g/dl Platelet 2,45,000cells/mm 3 1,50,000-4,00,000cells/mm 3 Blood sugar (FBS) 202 60-100

5. PARAMETER OBSERVED VALUE NORMAL RANGE Renal Function Tests: BUN 22mg/dl 8-23mg/dl Creatinine 0.8mg/dl 0.6-1.2mg/dl Sodium 135mmol/l 135-147mmol/l Potassium 4.8mmol/l 3.5-5.2mmol/l Chloride 98mmol/l 95-107mmol/l Bicarbonate 22mmol/l 22-30mmol/l Liver Function Tests: Total Bilirubin 0.7mg/dl 0.3-1.0 mg/dl Direct Bilirubin 0.3 mg/dl 0.1-0.3 mg/dl Indirect Bilirubin 0.4 mg/dl 0.2-0.7 mg/dl

6. PARAMETER OBSERVED VALUE NORMAL RANGE SGOT 22U/L 12-38U/L SGPT 34U/L 7-41U/L Albumin 4.3g/dl 3.5 – 5.3 g/dl Globulin 2.2g/dl 2-3 g/dl Total protein 6.5g/dl 5.5-9.0 g/dl Alkaline phosphatase 228U/L 84-306 U/L Gamma GT 28 U/L 5-50 U/L Prothrombin time 14 seconds 10-15 seconds Urine analysis: Colour yellow pH 6.0 Epithelial cells 0-2 Protein Trace

7. Other investigations Visible swelling of the testicles Culture sensitivity: Specimen: Urine - Growth observed (Culture positive) Urine acetone –negative Bleeding time -1’ 55’’ Clotting time 4’00’’ HbA1c: 7.2 USG Colour Doppler: Impression: Normal spermatic cords. Normal blood flow to both the testicles was observed.

8. Diagnosis: Orchitis Drug chart: Drugs Dose ROA Frequency No. of Days Glibenclamide + Metformin 2.5mg+ 400mg P/O BD X 1 Imipenem Cilastatin 1g IV TDS X 3 Ondansetron 4mg P/O BD X 3 Rantitidine 2ml IV TDS X 3 Otilinium bromide 60mg P/O BD X 2 T. Gelusil P/O BD X 3 T. B complex P/O OD X 3 Metformin 500mg P/O BD X 2 (Continued Human Lispro Insulin 30U SC OD X 2 (Continued

9. DISCHARGE ADVICE: T. Metformin – 500mg – 1-0-1 Human lispro – 1-0-0 (30U)

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