UHID: AMHL.
0002139042 AH - QF - WS - 14
Discharge Summary
Dept. of PAEDIATRICS
General Information
Type of Discharge None
UHID AMHL.0002139042
Ward/Bed No ,Bed no:P 20
Name Ms. DIVIJA PRAMANIK
Age 6Yr 10Mth 5Days
Sex Female
Address 59D PRANTIK SARANI PS-DUM DUM ,Kolkata,West Bengal
Primary Consultant Dr. KAUSTABH CHAUDHURI
MBBS,MD (Paediatrics),Clinical Fellow (Paediatric Critical Care),(PGI,
Chandigarh), Pediatric Critical Care Fellowship (NUH, Singapore)
PAEDIATRICS
Date of Admission 23-Jul-2025
Date of Discharge 26-Jul-2025
Diagnosis DENGUE FEVER WITH WARNING SIGNS.
History of Present Illness
CHIEF COMPLAINTS DIVIJA PRAMANIK, a 6-year-old girl, presented to the emergency with high
grade fever (max. temp. 104 F) for 5 days, now afebrile for last 1 day. She
also had pain abdomen with few episodes of vomiting 2 days ago.
There was no history of headache, cough, cold, loose stools.
She was having an itchy rash on both legs for 1 day, and burning sensation
while micturition.
There is history of Adenoviral infection 2 years ago.
Outside investigations revealed Dengue- NS1 antigen positive, with
leukopenia (TLC-2800/cu.mm.) and thrombocytopenia (1.24 L/ cu.mm.) and
was brought here for further management.
SOCIAL HISTORY
Page 1 of 6
UHID: AMHL.0002139042 AH - QF - WS - 14
SNOMED
SNOMED DENGUE FEVER WITH WARNING SIGNS.
Clinical Examination
Weight Kg Icterus Nil
Temperature °F Pulse /min.
B.P / mm of Hg.
Investigations Done
BioChemistry
ALBUMIN - SERUM
24-Jul-2025 12:13 AM
ALBUMIN - SERUM 4.1 g/dL 3.8 - 5.4
ALKALINE PHOSPHATASE - SERUM
24-Jul-2025 12:13 AM
ALKALINE PHOSPHATASE - SERUM 213 U/L Child(5 - 10yrs): 118-360
ALT(SGPT) - SERUM
24-Jul-2025 12:13 AM
ALT(SGPT) - SERUM 12 U/L Child (6-10yrs): 11-28
AST (SGOT) - SERUM
24-Jul-2025 12:13 AM
AST (SGOT) - SERUM 35 U/L Child Female (1-10 yrs) : 18-63
BICARBONATE - SERUM
24-Jul-2025 12:13 AM
BICARBONATE - SERUM 21 mEq/L 20 - 28
BILIRUBIN SERUM - TOTAL/DIRECT
24-Jul-2025 12:13 AM
BILIRUBIN TOTAL - SERUM 0.4 mg/dL < 2.0
BILIRUBIN CONJUGATED (DIRECT) - 0.1 mg/dL 0 - 1week: <0.9, Adult: upto 0.2
SERUM
CALCIUM - SERUM
24-Jul-2025 12:13 AM
CALCIUM - SERUM 9.2 mg/dL 8.8-10.8
CHLORIDE SERUM
Page 2 of 6
UHID: AMHL.0002139042 AH - QF - WS - 14
24-Jul-2025 12:13 AM
CHLORIDE - SERUM 108 mEq/L Child(5 - 15yr) :98-115
CREATININE - SERUM
24-Jul-2025 12:13 AM
CREATININE - SERUM 0.6 mg/dL 0.3 - 0.7
GLUCOSE - PLASMA (RANDOM)
24-Jul-2025 12:13 AM
GLUCOSE - PLASMA (RANDOM) 73 mg/dL 70-140
MAGNESIUM - SERUM
24-Jul-2025 12:13 AM
MAGNESIUM - SERUM 2.3 mg/dL 1.7 - 2.4
PHOSPHORUS, INORGANIC - SERUM
24-Jul-2025 12:13 AM
PHOSPHORUS, INORGANIC - SERUM 5 mg/dL 4-7
POTASSIUM - SERUM
24-Jul-2025 12:13 AM
POTASSIUM - SERUM 3.9 mEq/L Child(5 -10yrs) : 3.4-5.4
PROTEIN TOTAL - SERUM
24-Jul-2025 12:13 AM
PROTEIN TOTAL - SERUM 6.8 g/dL 5.7 - 8.0
Albumin/Globulin Ratio 1.5 1.0-2.0:1.0
GLOBULIN: (CALCULATED) - SERUM 2.7 g/dL 1.8-3.6
SODIUM - SERUM
24-Jul-2025 12:13 AM
SODIUM - SERUM 141 mEq/L 1-19 Yrs: 138 - 145
UREA - SERUM
24-Jul-2025 12:13 AM
UREA - SERUM 27 mg/dL 11 - 39
Clinical Pathology
URINE ROUTINE AND MICROSCOPY
24-Jul-2025 10:12 AM
Specific Gravity 1.020 1.016 to 1.025
pH: 6.5 4.6-8.0
Page 3 of 6
UHID: AMHL.0002139042 AH - QF - WS - 14
Albumin: Not Detected Not Detected
Glucose Not Detected Not Detected
Ketone: Not Detected Not Detected
Bile Pigments Not Detected Not Detected
RBC Nil /hpf 0-2/hpf
Pus Cells 1-2 /hpf 0-5/hpf
Colour: Pale Straw Watery / Pale yellow
Casts: Not Found Occasional hyaline cast
Appearance Slightly Turbid Clear
Crystals: Not Found Absent
Haematology
CBC
25-Jul-2025 07:34 AM
Hemoglobin 11.6 g/dl 11.5-15.5
Packed cell volume 38.5 % 35-45
Basophils 00 % 0-0
WBC Count 4600 /cu mm 5000-13000
Platelet Count 1.12 lacs/cumm 1.7-4.5
COMPLETE HAEMOGRAM
24-Jul-2025 12:13 AM
Hemoglobin 11.9 g/dl 11.5-15.5
Platelet Count 1.20 lacs/cumm 1.7-4.5
RBC COUNT 4.85 Million/ul 4.0-5.2
Basophils 00 % 0-0
Hematocrit - Hct: 38.3 % Healthy Women: 36 - 46
MCV 79.1 fl 77-95
MCH 24.6 pg 25-33
MCHC 31.1 % 31-37
RDW 14.4 % 11.8 to 14.0
WBC Count 4100 /cu mm 5000-13000
ERYTHROCYTE SEDIMENTATION RATE (ESR)
24-Jul-2025 12:13 AM
ERYTHROCYTE SEDIMENTATION 15 mm/1st hr 0-20
RATE (ESR)
Microbiology Serology
C-REACTIVE PROTEIN (CRP)
Page 4 of 6
UHID: AMHL.0002139042 AH - QF - WS - 14
24-Jul-2025 12:13 AM
C-REACTIVE PROTEIN (CRP): <0.298 mg/dl Normal < 0.5
DENGUE SEROLOGY ( IgM AND IgG )
24-Jul-2025 12:13 AM
Dengue Serology (IgM) Reactive(3.01) Reactive:Index>1.1,Borderline
Reactive:Index 0.9-1.1
Dengue Serology (IgG) Non reactive(0.43) Reactive:Index>2.2
PCT - Q (Procalcitonin)
24-Jul-2025 12:13 AM
Course In The Hospital & Discussion
This 6-year-old female child presented to the emergency with the above mentioned concerns and was admitted in
the pediatric ward. On examination she was alert, well perfused, hemodynamically stable, with normal systemic
examination. After sending relevant investigations, IV fluids were started along with other supportive measures.
Monitoring of vital parameters and fluid intake-output was continuously done.
Initial investigations showed leukopenia (TLC-4100), thrombocytopenia (1.2Lac), normal acute phase reactants and
biochemical parameters. Dengue- IgM antibody was reactive. Urine routine examination was within normal limits.
She remained afebrile and hemodynamically stable. Adequate hydration was maintained and IV fluids tapered down
as oral intake improved. Subsequent blood test showed rising trend in WBC and platelet count. Now she is being
discharged in hemodynamically stable condition with the following follow-up advice.
ADVICE ON DISCHARGE
DIET Normal diet with plenty of fluids.
Physical Activity Rest for 7 days.
SYP. P-500 (500MG/5ML)- 4ML ORALLY SOS FOR FEVER >100 F (AT LEAST 4-6 HOURS APART).
TAB ONDEM MD (4 MG)- 1 TAB ORALLY SOS FOR VOMITING (ATLEAST 8 HOURS APART).
SYP. ATARAX (10MG/5ML)- 5ML ORALLY TWICE DAILY FOR 5 DAYS.
DERMOCALM LOTION TO BE APPLIED OVER SKIN RASH THRICE DAILY FOR 5 DAYS.
SYP ZINCOVIT- 8ML ORALLY ONCE DAILY FOR 6 WEEKS.
SYRUO DUPHALAC: 10 ML ORALLY ONCE AT BEDTIME (DOSE TO BE ADJUSTED ACCORDING TO STOOL
FREQUENCY AND CONSISTENCY)
Follow Up REVIEW WITH DR KAUSTABH CHAUDHURI IN PEDIATRIC OPD AFTER 7 DAYS, OR
EARLIER SOS.
Page 5 of 6
UHID: AMHL.0002139042 AH - QF - WS - 14
PLEASE CALL EMERGENCY 1066 / 033-23203040 ,IF YOU HAVE ANY OF THE
FOLLOWING SYMPTOMS:
1. Fever Of 101°F
2. Onset of new pain or worsening of previous pain.
3. Vomiting.
4. Breathing difficulty.
5. Altered level of consciousness.
6. Discharge from the operative wound.
7. Worsening of any symptoms.
8. Other significant concerns.
Please visit our website: www.apollohospitals.com
* FOR ENQUIRY, APPOINTMENTS AND TELEMEDICINE CONSULTATIONS CONTACT 033-
23203040.
Dr. KAUSTABH CHAUDHURI
MBBS,MD (Paediatrics),Clinical Fellow (Paediatric Critical
Care),(PGI, Chandigarh), Pediatric Critical Care Fellowship
(NUH, Singapore)
PAEDIATRICS
Primary Consultant
Please understand your discharge prescription from your doctor before using the medicines.
_________________________________________________________________________________________________________
You can contact Emergency Room Physician, Apollo Multi Speciality Hospitals ltd. at or 033-6060-1066.
Typed by 921613 Page 6 of 6
