CASE PRESENTATION 1

1. CASE PRESENTATION ON
MALARIAL FEVER
N.MANGALABARATHI
BSC NURSING

2. SUBJECTIVE
• Patient name: Mr. G
• Age: 62yrs
• Sex: Male

3. SUBJECTIVE Contd...
CHIEF COMPLAINTS:
c/o Fever present since 4 days
Fever increased since today morning
vomiting sensation present after take of
food and general fatigue
PAST MEDICAL HISTORY:NIL
MEDICATION HISTORY : NIL
ALLERGIES IF ANY: NIL

4. OBJECTIVE
• PHYSICAL EXAMINATION:
Patient conscious, oriented and febrile
• VITAL SIGNS:
Vital/date Day 1 Day 2 Day 3 Day 4
Temp(F) 101 99 98.4 98.4
Pulse(/min) 84 82 84 84
BP(mm/hg) 110/70 100/60 110/70 110/70
RR(/min) 22 20 22 22

5. OBJECTIVE Contd..
• LABORATORY INVESTIGATION
CONSTITUENTS DETECTED
VALUES
NORMAL
RANGES
RBC 4.25 4.5-5.5
million/cumm
WBC 4,440 4000-11000
cells/cumm
Hemoglobin 12.3 13-17g/dl
Platelet count 1.70 1.5 -4 lakh
cells/cumm
ESR 1/2 hr : 05mm
1 hr :17mm
0-22mm/hr

6. OBJECTIVE contd..
HCT 33.67% 45-52%
MCV 79 fl 80-100 fl
MCH 29 pg 33-37g/dl
Sr.creatin 0.73mg/dl 0.6-1.2mg/dl
Cholesterol 140 mg/dl < 200 mg/dl
HDL 36.5 mg/dl > 40 mg/dl
LDL 87.1 mg/dl <130mg/dl
VLDL 22.4 mg/dl 2-30 mg/dl
ALP 163 u/l 40- 129 u/l
AST 33 u/l 5-38 u/l
T.Bilirubin 0.66 mg/dl 0.1-1.2 mg/dl
D.Bilirubin 0.21 mg/dl 0- 0.3 mg/dl

7. Objective cont…
INR 0.45mg/dl 0.2-0.8mg/dl
Blood urea 23.3 mg/dl 7- 20 mg/dl
Sr . urea 3.72 mg/dl 7- 20 mg/dl
Sr . calcium 8.6 mg/dl 8.6- 10.2 mg/dl

8. ASSESSMENT
INTERPRETATION
 SUBJECTIVE:
A 62 years old patient was suffered from
fever for 4 days , fever increased today morning.
vomiting sensation present after take of food
and general fatigue
 OBJECTIVE:
From lab investigations, alkaline phosphate
and blood urea was found to be elevated .
RBC was slightly decreased.

9. ASSESSMENT
• DIAGNOSIS:
MALARIAL FEVER

10. PLAN (DRUG THERAPY)
S.
NO
DRUGS TO BE
PRESCRIBED
DOSE ROA Freq Day
1
Day
2
Day
3
Day
4
1 Tab. Chloroquine 250mg oral Bd   
2 Inj . Areteether 75 mg IM Od   
3 Tab. Mosapride 5 mg oral Tds   
4 Tab. Doxycycline
hycolate
100
mg
oral SOS 
5 Inj .ondansetron 4mg IV Od  
6 Inj . Pantoprazole 40 mg IV Bd    
7 Inj. paracetamol 1 gm IV B.D   
8 Cap. Papaya leaf
extract
Oral B.D    
9 Syp. Lactitol +
Benzoic acid
15 ml oral H.S   

11. PLAN
10 Cap .lamivudine 150mg oral Bd    
11 Syrup. Sucralfate 10ml oral Bd    
12 Tab. paracetamol 650 mg oral Bd 
13 Inj. lorazepam 2mg Iv H.S   
14 Inj. Pipercillin/
tazobactum
4.5g Iv OD  
15 Ivf. Dextrose + sodium
chloride soln.
Iv BD   

12. PLAN contd..
• TREATMENT PROGRESSION:
tab . Chloroquine – antimalarial drug. It will interfere
with the growth of parasites in the RBC
inj. Arteether – antimalarial drug. Used to treat malaria
that are resistant to other drugs. Mainly used for the
malaria caused by p.falciparum.
tab.mosapride - gastroprokinetic agent. Used to increase
the movement of food from stomach to the intestine.
Tab.doxycycline- tetracycline antibiotic. Used as a
prophylaxis for malaria.
Inj.ondansetron – antiemetic. Used to prevent nausea and
vomiting.

13. PLANcontd..
Syrup- sucralfate – antiulcer drug. used to treat
ulcer
Inj. Lorazepam - benzodiazepines, which increase
sedation
Cap.lamivudine - an antiretroviral drug, to treat
hepatic infection
Tab.paracetamol - an antipyretic, to reduce fever.
Inj. Pantoprazole – proton pump inhibitor . Used
to reduce the acid secretion of the stomach.

14. PLAN
• PLAN ON DISCHARGE:
Rx
Tab.paracetamol 500 mg B.D
Cap.Anvir 150 mg B.D
Cap.thromb up. B.D
continue these medication and follow the
normal diet.

15. PHARMACIST INTERVENTION:
• DRUG INTERACTIONS:
Doxycycline + pyridoxine – doxycycline will
increase the level or effect of pyridoxine by
altering the intestinal flora .

16. PLAN
• PATIENT COUNSELING:
EDUCATION PLAN:-
 Always correct the dose of medication to be
continued
 Apply insect repellent when exposed skin.
 Use mosquito net while sleeping.
 Keep your environment clean.

17. PLAN
DIETARY PLAN:
 Avoid eating oily and spicy food as they can disrupt the
digestion process and also it will aggravate the recovery.
 Eat healthy diet that provides adequate nutrition.
 Drink plenty of water and fluids to keep the body well
hydrated. It will also help to flush the parasites out.
 Include omega 3 fatty acid foods that helps to reduce the
inflammation.
 Eat a healthy diet rich foods like carrot, beetroot,
papaya, orange, berries, lemon, etc., as it will help to
detoxify the body.

18. PLAN
• Avoid or limit the fat intake. Excess fat in diet
may aggravate nausea.
• Tea and coffee should be avoided during
malarial treatment.

19. …
THANK YOU