35 year female viral pyrexia

35 yr female farmer by occupation came to OPD complaining of fever 
Lower abdominal pain 
Lower back pain
Burning micturition
Cough since 6days
Hopi. Patient was apparently asymptomatic 6months back she had fever followed by painful swelling of both hand  small joint pains and lower limb ankle joint pains and swelling for which he went to a private hosp at miryalaguda and got treated
Nw she is complaining of fever assosiated with chills and rigours and evening rise of temperature assosiated with lower back nd lower abdominal pain n burning micturition  since 6days and dry cough since 2 days for which she got admitted in private hospital and got investigated and found to have rt pyelonephritis in the scan
Personal history
Patient appetite normal
Diet mixed
Sleep normal
Addictions nil
Bladder burning micturition
Bowel regular
Past history
Patient had fever with joint swelling inlast 6 months back
Is not a know case of Htn DM asthma cad eilepsy 
Patients husband used 1 year att for pulmonary kochs 2years back
General examination
Pt is c/c/c
Bl pedal edema present 
No pallor  icterus no clubbing no cyanosis, lymphedenopathy, koilonychia 
Temp 97.2f
PR 102bpm
Rr 14cpm
Cvs s1s2
Rs Bae
Pa soft tenderness present rt iliac fossa
CNS NAD 



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