HOPC:
4 weeks ago, Mr P developed a sudden episode of watery diarrhoea that has not resolved over. He has 4 diarrhoeas 8-12 times a day. No blood, mucous seen in the stool. Volume of the fecal material is high. His normal bowel motion is 1/day. He also developed fevers, chills and rigors &abdominal cramps during day 1 and 2 but has not have any of this symptoms since then.
Other relevant negatives (considering he is immunocompromised)
- No LOW, night sweats, lack of appetite.
- No cough, sputum, SOB.
- No chest pain, palpitations.
- No symptoms of UTI but has noticed a low volume of urine output (10-15mL). Claims to be dehydrated.
- No fainting, dizziness, blackouts.
- No Neurological signs.
He presented to the GP on day 2 and was subsequently admitted to hospital last week and treated.
- I- flu vaccination is up to date
- Contact - works with children (prone to norovirus, adenovirus, rotovirus diarrhoea). Last worked? No other sick contacts.
- Travel - No travel. Any dubious food? Any stream water or tank water?
- O - irrelevant
- A- lives with a cat
- D- imunnosuppressive drugs + cardiac drugs.
- Sex - never ask.
Med Hx.
- PCKD diagnosed during the 80's. Currently on 3rd transplant. First transplant lasted 4 days. His last transplant was in 94'. On immunosupressive drugs for it. Has 1 URT infection/ 2mths. and also occasional diarrhoea. Attributed to him working with children. Hospital admissions for complications?
- Cardiac disease with triple bypass done? any symptoms? PND, orthopnea, pillows used, exercise tol?
Medication?
Family history?
Social history?
- Live with? Family, children?
- DALYs?
- Support?
- Finanacially stable?
- depressed?
- Smokes, drink?
- exercise
- diet
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