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A 65 yr old female with pedal edema and facial puffiness

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This is an online E logbook to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent.  Here we discuss our individual patient’s problems through series of inputs from an available global online community of experts to solve those patients clinical problems with collective current best evidence-based inputs.  This e-log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box are welcome. A 65 year old female came to opd with the chief complaints of fever since 20days ,pedal edema and facial puffiness  from the following day  History of present illness  Patients was apparently asymptomatic 20days ago then she developed fever which is insidious in onset gradually progressive ,low grade fever, intermittent,     Associated with body pains not associated with chills and rigors and weight loss  No history of nocturnal variation of fever  Patient when got fever 20days back she ignored