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A detailed account of a case study of a 38-year-old female patient who was brought to the ER due to loss of consciousness and was later diagnosed with typhoid fever. The patient had been experiencing high-grade remittent fever, headache, cough, body malaise, anorexia, and crampy right lower quadrant abdominal pain, which was followed by bloody stools. The patient had a history of diabetes and had been compliant with Metformin treatment. the patient's vital signs, physical examination findings, laboratory test results, and diagnosis. This case study can be useful for medical students and healthcare professionals to understand the symptoms, diagnosis, and treatment of typhoid fever.
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The patient had been diagnosed to have diabetes a year ago and had been on Metformin 500 mg taken orally once a day with good compliance. Last consult was done 3 months ago and the FBS taken that time was 110 mg/dL. She does not smoke nor drink alcoholic beverages and she started exercising regularly a year agno. She is a teacher at a public school. There are no known heredo-familial diseases.
At the ER, examined an obese patient who was brought in per stretcher, extremely weak and drowsy. Vital signs: BP = 70/40 HR = 120 beats/min RR = 26cycles/min Temp = 38.5C Skin: warm, no rashes, good turgor HEENT: pale palpebral conjunctivae; anicteric sclerae; dry lips and tongue Chest/Lungs: equal chest expansion, good air entry; no rales, no wheezes CVS: adynamic precordium, tachycardic , regular rhythm, soft S1 at the apex; loud S2 at the base; no S3 and S Abd: flabby; hypoactive bowel sounds; soft; tender at the right lower quadrant ; no involuntary guarding, Ext: thready pulses ; cold clammy hands and feet , delayed capillary refill time , pale palms no pedal edema, Rectal exam: tight sphincter tone, no mass/hemorrhoids, no tenderness , fresh blood on examining finger Neuro Exam: drowsy , arousable to verbal stimulus ; appropriate but limited verbal response to queries , no slurring of speech; spontaneous purposeful movement with no apparent motor deficit.