46 year old , male resident of Devarkonda occupation : driver

Came for regular dialysis 

During dialysis , he developed cough with hemoptysis ( 200ml ) saturations: 60spo2, got intubated. 

Past h/o : patient was apparently normal 8 months back, then he developed back pain , burning micturition, loss of appetite , decrease urine output. 

Back pain which was insidious on onset , gradually progressive no reliving and aggrevating factors for which he went to a near by RMP , pain subsided. 

After 2 months he developed sudden SOB, went to devarkonda hospital , For which they said he has kidney problem, had to go for dialysis. 

Later, he came to Kamineni Narketpalli 

Underwent dialysis , during dialysis he had COUGH, SOB, FEVER. 

Totally 10 dialysis done till last month. 

During the stay in hospital, he had one episode of seizures ( GTCS  type) not a k/c/o seizures 

On tab: LEVIPIL. 

Later he was discharged , he was sent to Hyderabad for FISTULA . 

On the way , going to Hyderabad attenders observed , he was unable to talk and weakness of both UL and LL

He was got to Kamineni back , high grade fever & was in altered sensorium 

? Uremic encephalopathy. 

? Catheter induced infection. 













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