Orchitis-Case Study

CASE PRESENTATION ON ORCHITIS

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 Illness:

H/O left abdominal pain

H/O decreased appetite

Past Medical History:

K/C/O DM 15 Years

Past Medication History:

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

LAB INVESTIGATIONS

PARAMETER OBSERVED VALUE NORMAL RANGE

Hemoglobin 14.8g/dl 14-18g/dl

RBC 4.7millions/mm3 4.5-5.6million/mm3

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 13500cells/mm3 4000-11000 cells/mm3

MCV 91.6 80-96fl/red cells

MCH 30.2 26-33pg/cells

MCHC 33 31-36g/dl

Platelet 2,45,000cells/mm3 1,50,000-4,00,000cells/mm3

Blood sugar(FBS) 202 60-100


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


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

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.

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

DISCHARGE ADVICE:

1. T. Metformin – 500mg – 1-0-12. Human lispro – 1-0-0 (30U)

THANK YOU

Education

Orchitis-Case Study