GENERAL DATA SALIENT FEATURES

Name: K.S. • FEVER AND MALAISE

Age/Sex: 19/Female
Marital Status: Single
Home Address: Cabugao,
Apayao
Present Address: Ugac Norte,
Tuguegarao
Religion: Roman Catholic
Nationality: Filipino
Occupation: Student
• HEADACHE
• VOMITTED 4 TIMES WITH
YELLOWISH TO WHITISH
PHELGM.
• ABDOMINAL PAIN AT
HYPOGASTRIC REGION
• NAUSEA AND VOMITTING
• JOINT PAIN AND MALAISE
• INJECTED CONJUNCTIVA

Chief Complaint: Headache, Fever and Malaise

PROBLEM LIST:
Fever, Nausea, Vomiting, Joint pain, Injected conjunctiva
TY P HO I D F EV ER

Typhoid fever (aka enteric fever), is a multisystemic illness caused primarily by Salmonella enterica
serotype typhi and, to a lesser extent, S enterica serotypes paratyphi A, B, and C. Infection occurs with
ingestion of contaminated food and water. All pathogenic Salmonella species, when present in the gut
are engulfed by phagocytic cells, which then pass them through the mucosa and present them to the
macrophages in the lamina propria. Nontyphoidal salmonellae are phagocytized throughout the distal
ileum and colon. With toll-like receptor (TLR)–5 and TLR-4/MD2/CD-14 complex, macrophages
recognize pathogen-associated molecular patterns (PAMPs) such as flagella and lipopolysaccharides.
Macrophages and intestinal epithelial cells then attract T cells and neutrophils with interleukin 8 (IL-8),
causing inflammation and suppressing the infection. It has a Variety of presentations that range from an
overwhelming multisystemic illness to relatively minor cases of diarrhea with low-grade fever. The
classic presentation is fever, malaise, diffuse abdominal pain, and constipation.
PROBLEM LIST:
Fever, Nausea, Vomiting, Joint pain, Injected conjunctiva
TY P H OI D F EV ER

rule in: rule out:

HEADACHE (-) ROSE SPOTS
FEVER (-) HEPATOSPLENOMEGALY
MALAISE (-) RELATIVE BRADYCARDIA
VOMITING (-) COUGH
JOINT PAIN (-) DIARRHEA
NAUSEA
LIVING IN A BOARDING HOUSE TYPHOID IGM/IGG TO RULE OUT
(STUDENT) (TUBEX OR WIDAL TEST)
RED EYES/INJECTED BLOOD CULTURE TO RULE OUT
CONJUNCTIVA (ALTHOUGH RARE) STOOL CULTURE TO RULE OUT
PROBLEM LIST: V IRA L
Hypogastric pain, Vomitting, Fever, Headache G AS T ROE NTER ITI S

Viral gastroenteritis is an intestinal infection caused by several different

viruses including rotavirus, norovirus, adenovirus, and astroviruses. Most are
transmitted via the fecal-oral route, including contaminated food and water.
Isolated cases can occur, but viral gastroenteritis more commonly occurs in
outbreaks within close communities such as daycare centers, nursing
facilities, and cruise ships. Regardless of the viral cause, treatment is
generally uniform and directed toward symptomatic improvement with a
focus on hydration status.
PROBLEM LIST: VI RA L
Hypogastric pain, Vomitting, Fever, Headache GA S TRO ENT ERI TIS

rule in: rule out:

FEVER (-)WATERY DIARRHEA
HYPOGASTRIC PAIN (-)WEIGHT LOSS
VOMITTED 4 TIMES (-)TACHYCARDIA, TREADY PULSE
HEADACHE AND HYPOTENSION(SEVERE
LIPS ARE SLIGHTLY DARK AND DEHYDRATION)
DRY (DEHYDRATION)
PROBLEM LIST: F OO D P O IS O NI N G
ABDOMINAL PAIN AT HYPOGASTRIC REGION

Food poisoning is defined as an illness caused by the consumption of food or

water contaminated with bacteria and/or their toxins, or with parasites,
viruses, or chemicals. The most common pathogens are Norovirus,
Escherichia coli, Salmonella, Clostridium perfringens, Campylobacter, and
Staphylococcus aureus.

Most of the illnesses are mild and improve without any specific treatment.
Some patients have severe disease and require hospitalization, aggressive
hydration, and antibiotic treatment.
PROBLEM LIST: F OO D P OI S ON IN G
ABDOMINAL PAIN AT HYPOGASTRIC REGION

rule in: rule out:

(-) DIARRHEA
FEVER
(-) BLOATING
HEADACHE
(-) HISTORY OF EATING RAW/
ABDOMINAL PAIN
UNDERCOOKED MEAL
VOMITING