Potlapallirashmitha

  Here's a case that I have seen -  A 55 year old male, shepherd by occupation, presented to the OPD with the chief complaints of fever (on and off), loss of appetite, headache, body pains, generalized weakness since 2 months, cough since 2 weeks and vomitings and pain abdomen since 2 days.  The patient was apparently assymptommatic 2 months back  Then he developed fever which was insidious in onset, low grade fever, intermittent type. It is associated with chills and rigors There are no aggravating factors and the fever was relieved on taking medication  (For which he visited the RMP) It is associated with generalized weakness, headache (diffuse), neck pain, loss of appetite and weight loss.  It is associated with cough since 2 weeks It is productive in nature. The sputum is mild in quantity, white in colour, non-purulent, non-blood stained, non-foul smelling.  H/O shortness of breath on exertion  H/O vomitings since 2 days  1 episode/day containing ingested food particles.  Non-b