45yr male with RASH

Chief complaints:::.  
        45 yr male came with complaints of Rash on Rt.and Lt.THIGH and RT.FORE ARM since 2week
History of present illness::

        Patient was apparently asymptomatic 2 days back then he developed RASH ON both thighs and Rt fore arm.  
    which was not associated with fever, and initially associated with itching which relieved on medication .Rash was sudden in onset not progressed.

Routine history::

Pt. Was farmer by occupation ,his routine was not disturbed before this incident he daily goes to his farms works and not  disturbed with any symptoms

Past history:

No similar complaints inpast 
H/o. Injury to both legs previously  6months back
A non healing wound was present in LT.Toe
No h/o. DM,HTN,EPILEPSY,TB


PERSONAL HISTORY::

diet:mixed
Appetite: normal
Bowel and bladder:: Regular
Sleep: adequate
Addictions:: occasionally alcoholic

Drug history::
Not allergic to any drug
No food allergies

General examination::

Prior consent taken
Examined in well lighted room
Pt. Was conscious coherent cooperative
Built:: Thin built
NO PALLOR ,ICTERUS,CYANOSIS,PEDAL
 OEDEMA, 
GENERALIZED LYMPHADENOPATHY:::SEEN OVER NECK


Vitals ::
Bp 140/90
Temp.afebrile
Pulse rate:80b/min
Respiratory rate:18c/min
Spo2::98 at (room atmospheric air)

Systemic examination::

CVS::

S1 S2  HEARD
NO MURMURS

Respiratory system: 

No wheeze,
No dyspnoea
Chest b/l symmetrical
Trachea central

CNS:

Consious
Speech: normal 
Kerning sign: -ve
No neck stiffnes

Investigations::
Hiv :: REACTIVE

provisional diagnosis:: idiopathic THROMBOCYTOPENIA??HIV INFECTION

MANAGEMENT::
Ivf
Inj.neomol
Inj.pan 
Monitor platelets countcount
Monitor vital 2hrly







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