3. Referred from local hospital
c/o fever of 1 month duration
Treatment till then unsuccessful
Common infective causes ruled out
Next line of workup started
4. Pt had :-
Arthritis
Oral ulcers
Serositis (pleural and pericardial effusions)
Anaemia + High LDH + DCT positivity
Anti ds-DNA positivity
6. Started on steroids
Pt afebrile by end of 1st week
General condition improved
7. New c/o cough and recurrence of fever
Pt in 2nd week as IP
Lt sided chest pain
Scanty expectoration
8.
9.
10. Pt on steroids
New onset cough and pleuritic pain
New patches on chest X-Ray
First suspect:-
INFECTIVE AETIOLOGY
Added antibiotics
CT chest taken
11.
12.
13. Consolidation with air bronchogram in the
apicoposterior segment of left upperlobe
Minimal right pleural effusion with basal
atelectasis
Moderate pericardial effusion
14. After 2 weeks of antibiotic therapy
Bouts of fever persisting
Cough persisting
Chest pain has become right sided
Repeat chest X-Ray
15.
16. Suspicion shifted to the next accused:-
Lupus Pneumonitis