A 57 year old male patient with bilateral pedal edema

57 year old male farmer by occupation
Came with complaints of fever since 3 days

Patient was apparently asymptommatic 4 months back then he developed
Bilateral pedal edema, pitting type, insidious in onset, gradually progressive from ankle to below knee
Decreased urine output
Patient went to the outside hospital were renal function tests were done and he was found to have raised urea and creatinine levels
Patient was taken for dialysis (total of 4 dialysis were done).
He was diagnosed with hypertension at the same time and is on regular medication( Tab. NICARDIA 10MG).
Patient came to our hospital for dialysis and central line placement was tried but failed and hence patient was put on conservative management.
Patient now complaints of fever, low grade, intermittent, relieved with medication.
He also complaints of cough with expectoration, cold since 4 days.
No history of shortness of breath, chest pain, palpatations.
He is hypertensive since 4 months
Patient takes alcohol (180ml 2-3 times/week)
Smokes beedi (2-3/day)
History of NSAID's abuse (takes tablets when he has knee joint pains)

Comments

  1. Please eloborate history and add appropriate clinical images ,and Lab investigations - like Renal function test ,which is important for this case .

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