A 70 year old patient with c/o of Altered sensorium since 3 days
Patient was apparently asymptomatic till afternoon (21jan2021) then she developed altered sensorium ,after she had her afternoon lunch and took a nap and when she woke up her daughter in law noticed abnormal behaviour (not recognizing her, murmuring).H/o fever 4days back which was sudden in onset gradually progressive & not present throughout the day and also subsided on taking medication.H/O neck pain and shoulder pain for which she was taken to the near RMP for which she was given NSAIDS.No H/o of chest pain, palpitations, burning micturition,SOB,pedal edema.Not a K/C/O of DM and HTN K/C/O alcoholism (occasionally) 50ml . O/E pt was c/c/c. Pallor - Icters- Cyanosis- Clubbing- Edema- Dehydration+ Dry tongue+ Vitals BP 130/80mm Hg Temperature 99.6°F PR 86bpm CVS-S1 S2 heard RS - BAE +,NVBS P/A soft and non tender,no organomegaly, passage of stools +. CNS examination LT RT Tone N N Powe