1d. A patient with fever, headache and bodyache

Case history- A 15 years old boy presents with 3 days fever with headache and bodyache. Two of his family members and a few of his neighbors also suffered from same problem and recover spontaneously.

What would you consider as differential diagnosis?

Influenza

Dengue fever

What key questions would you ask?

Fever- Sudden onset of pyrexia with generalised aching, headache, anorexia, nausea and vomiting, and harsh unproductive cough.

History of suffering others in same illness.

History of rash and bleeding from mucosal surface like gum- dengue fever

 What will you examine?

          General examination- Patient is ill looking; temperature is raised but no rash.

Systemic examination- no abnormality or organomegaly.

Clinical diagnosis- Influenza 

Treatment-

• Bed rest.
• Paracetamol 0.5-1 g 4-6-hourly.
• Pholcodine 5-10 mg 6-8-hourly for cough.
• Most recover within 3-5 days, but may be followed by ‘post-viral syndrome’ with debility that persists for weeks.