Dr. Nadeem Abootty
Diabetologist
Hi Dr Rawat
From the details provided by you ,for me itseems this patient is suffering from pyelonephritis with impending urosepsis.
It's better to admit and start on IV antibiotics and avoid nephrotoxic medications.
If on OHA better convert to Insulin for time being.
monitor I/O, creatinine, ABG and electrolytes.
better do an urine acetone to rule out DKA.
thrombocytopenia may be due to sepsis or even the splenomegaly shown in USG may be of chronic ITP in background.
26.Apr, 11:53am