60 year old male , R/o Nakrekal , Farmer by occupation came with the

Chief complaints 

Decreased urine output since 20 days
Abdomen distension since 1 week
Shortness of breath since 1 week 

History of present illness 

Patient was apparently asymptomatic 20 days ago the developed high grade fever , continuous , assosiated with chills and rigors for which he was admitted to local hospital medications and they put foleys catheter and patient symptoms were  relieved .
• Patient complaining of decreased urine output since 20 days 
• Abdomen distension not a/w pain or tenderness 
• SOB since 1 week  Grade 3 proggresses to Grade 4 .
 H/o Orthopnea 
H/o Burning micturation 
No H/o PND 
No H/o Vomitings , Loose stools 


History of past illness 

Patient had a trauma over right bigtoe which was not healing  for which toe was amputated 3 years ago

Patient also had a trauma over right lateral aspect of leg . And healed 1 month ago

1 month ago before comming to our hospital . Pt was admitted in a local hospital for High grade fever for which he was treated symptomatically .







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