A8y

rol
dfemal
echi
ldbr
oughtt
ohospi
talbymot
herwi
thcompl
aint
sof

Puf
fi
nessoff
ace-15day
s

Swel
li
ngoff
eet
-10day
s

Hi
stor
yofpr
esenti
ll
ness:

Chil
dwasappar
entl
ynor
mal15day
sago,
thendev
elopedpuf
fi
nessar
ound
eyessi
nce15days,
Swell
ingoffeetinnext5days,
thatwasgr
adual
lyi
ncr
easi
ngandpr
ogr
essedt
o
abdominaldi
stensi
oninnext2days.
C/
odecr
easedur
ineoutput
.
 Nohi
stor
yofal
ter
edcol
our
edur
ine
Nohi
stor
yofhemat
uri
a/col
acol
our
edur
ineandbur
ningmi
ctur
it
ion.
Nohi
stor
yofbr
eat
hlessness,
pal
pit
ati
ons
Nohi
stor
yoff
ever
,cough,
col
d
Nohi
stor
yofj
aundi
ce,
vomi
ti
ngs,
abdomi
nalpai
n,l
oosest
ool
s
Nohi
stor
yofr
ash,
lesi
onsov
ershi
n
Nohi
stor
yofheadache,
blur
ri
ngofv
isi
on
Pasthistor
y:
Hist
oryofsimilarcomplai
ntsinthepastfor7t
imes,
fir
stepisodeatageof2
year
s,admi t
tedfor3weeksanddi schar
gedonoralmedicat
ion,l
ateronr
epeat
ed
admissionsforsimil
arcomplai
nts

Lastepi
sodewasi
nMar
ch2020
Fami
lyhi
stor
y:
Ni
lSi
gni
fi
cant
I
mmunisati
onhist
ory:
Compl
etel
yimmunisedt
il
ldat
e,BCGscarpr
esent
.

Bi
rt
hhi
stor
y:Nor
mal

Devel
opment
alhist
ory: Normal
GENERALPHYSICALEXAMI NATION:

Consci
ousandcoher
ent
Per
ior
bit
alpuf
fi
nesspr
esent
 HR-88bpm
RR-20cpm
BP-120/
80mmhgi
nri
ghtupperl
imbsupi
neposi
ti
on
Wei
ght
-45kgs,
hei
ght
-129cms,
Ey
es,
oralcav
ity
,nose,
ear
s,neck-nor
mal
Abdomi
naldi
stensi
onpr
esentski
nov
ert
heabdomenshi
ny
Bi
lat
eralpi
tt
ingpedaledemapr
esent
.
PerAbdomen:
OnI
nspect
ion
Uni
for
mlydi
stensi
onSki
n-shi
ny
Umbi
li
cus-ev
ert
ed,
hor
izont
alsl
itpr
esent.Al
lquadr
ant
smov
ingequal
ly
wi
th
 r
espi
rat
ion/
noscar
s/v
isi
blev
eins/
pul
sat
ions/per
ist
alsi
s
I
ngui
nalor
if
ices-nor
mal
Geni
tal
ia:edemat
ousscr
otalswel
li
ngpr
esent
PALPATI
ON:
Nol
ocalr
iseoft
emper
atur
e,not
ender
ness,
noor
ganomegal
y
Abdomi
nalgi
rt
h-94cms
Per
cussi
on-l
iverspan7cms,
shi
ft
ingdul
lnesspr
esent
Auscul
tat
ion-nor
mal

OTHERSYSTEMS:nor
mal