Manohar Subedi, a 33-year-old female, was admitted to the hospital after consuming wild honey and experiencing dizziness, chest burning, palpitations and sweating. Her blood pressure was low upon admission. She was treated with IV fluids, medications to increase blood pressure like dopamine and ondem, and pantocid. Her symptoms resolved with treatment and her vitals stabilized before being discharged with advice to follow up in two days and drink plenty of fluids.
1. Z
KATHMANDU MEDICAL COLLEGE& TEACHING HOSPITAL
Sinamangal, Kathmandu, Nepal
: 4476152, 4469064*
DISCHARGE
DEPARTMENT OF INTERNAL MEDICINE
Name of the patient: MANOHAR SUBEDI
Age/Sex: 33YRS/FEMALE
IP no: 164569
Address: KATHAMNDU
Bed no: 124
Date of Admission: 2079/06/25
Date of Discharge: 2079/06/27
Case Summary
Patient was presented to ER with alleged of consumption of 2 table spoon of wild honey with a glass of water followed by
dizziness , burning sensation of chest , palpitations and sweating . BP was low . He was taken to thimi hospital and 2 pint NS
given after which symptoms resolved.
No history of bleeding .
No history of abnormal body movement, LOC, frothing from mouth, up-rolling of eyes.
No history of loose stool , abdominal pain , burning micturition.
Past history:
No history of DM, HTN, thyroid disorder .
Personal history:
Stopped smoking 6 months back , occasional drinker .
EXAMINATION AT THE TIME OF ADMISSION:
On examination:
S/E:
Chest: NVBS, no added sounds
CVS: S1S2M0
P/A: Soft, non-tender , non distended.
CNS: GROSSLY INTACT
INVESTIGATIONS 2079/06/25 2079/06/26
HB/PCV 12.5 12.3
TC 13400 9400
DC(N-L) 80-16 60-36
PLATELETS 216000 186000
RBS 126
UREA/CR 44/1.5 25/0.8
NA/K 140/4.5 136/3.7
TB/DB 1.7/0.4
SGPT/SGOT 30/32/160
PT/INR 10/1.0
CA 8.6
Mg 2.3
CPK NAC 254
G/C – conscious, alert
PILCCOD- NIL
VITALS:
Temp: 102.4 F
Pulse:60bpm
RR- 20/min
BP- 80/50mm of Hg
SPO2-98% in RA
DIAGNOSIS: WILD HONEY POISONING WITH HYPOTENSION
DEPARTMENT OF INTERNAL MEDICINE
PROF DR. MATHURA KC
ASST. PROF. DR. SUBASH PANT
DR. ALOK DHUNGEL
DR. ANANTA ARYAL
DR. SUNIL ACHARYA
DR. ABISHKAR ACHARYA
2. Z
Treatment in the Hospital:
Patient presented to ER and was admitted to MEDICINE ICU and then shifted to general medicine WARD and where he was evaluated
and managed with, IV FLUIDS, INJ DOPAMINE, INJ ONDEM ,INJ PANTOCID and other supportive management. She is being
discharged after her vitals are stable.
CONDITION AT DISCHARGE:
VITALS:
Pulse: 80bpm
RR: 20min
Temp: 98.7F
BP: 140/90mm of Hg
SpO2: 96% in RA
TREATMENT AT DISCHARGE
1. TAB
2. TAB
ADVICE:
DRINK PLENTY OF FLUIDS .
FOLLOW UP IN MEDICINE OPD IN 2 DAYS/SOS WITH CBC, PCV REPORTS
____________________
SIGNATURE OF RESIDENT
DR. LAXMAN KHATI
NMC NO : 26732
G/C: Fair
PILCCOD –Nil
S/E:
P/A: Soft, non-tender, bowel sound present.
RS: NVBS, B/L equal air entry
CVS: S1S2M0
CNS: Grossly intact