A 30 year old female with right sided pneumonia

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A 30 year old female who is a house wife came to casualty at 11.00 pm with c/o fever since 10 days cough since 10 days and shortness of breath since 2 days. 

Patient was apparently asymptomatic 10 days back later she developed fever which was insidious in onset low grade with evening rise of temperature not relieved on medication associated with chills and rigors 
Fever is associated with dry cough since 10 days not associated with any postural or diurnal variation, cough is associated with pain in right side of chest. Cough was progressive associated with shortness of breath since 2 days more in the evening 
No PND, orthopnea, 
Not a k/c/o HTN, DM, asthma, epilepsy, CVA, CAD 
No h/o pedal edema, chest pain, palpitations, headache, tinnitus, blurring of vision 
On examination: 
No signs of pallor, icterus, cyanosis, clubbing, lymphadenopathy, pedal edema 
No signs of malnutrition or dehydration 
Vitals: 
Temp: 98.4OF 
PR: 92/ min 
RR- 28/min 
BP- 90/60 mmhg 
SpO2- 98% on RA 
GRBS- 156 mg/dl 
Systemic examination:
    I examined the patient in sitting position
Respiratory examination:
     Inspection:symmetry of chest is elliptical
 No engorger veins,scars,sinuses,no swellings 
No kyphosis and scoliosis
RR-30 beats / min
No usage of accessory muscles
Position of trachea -central
Chest movements are normal
Palpation:Inspectory findings are confirmed by palpation 
No tenderness and no rise of temperature 
Trail sign- position of traches slightly towards right
Apical impulse -5th intercoastal plane
Chest movements -decreased on right side 
Percussion -Dull on right side 
Auscultation -decreased breath sounds on right side 
Crepitations heard on right side 
CVS
S1 S2 heard 
 CNS 
patient is conscious, coherent and cooperative 
Speech- normal 
No signs of meningeal irritation 
Cranial nerves intact 
Reflexes intact 
No cerebellar signs 
Provisional diagnosis : 
Right upper lobe posterior segment consolidation 
Rt lower lobe consolidation 
Bilateral patchy consolidations 
Pneumonia 

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