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47 year old male with fever ,headache and altered sensorium

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  CHIEF COMPLAINTS : Patient came to the hospital with the chief complaints of - fever , headache , altered talking ,walking n confusion. HOPI : Patient was apparently asymptomatic 5days back .Then developed-  High grade fever with chills, intermittent in nature, relieved on medication and was associated with  headache. Altered sensorium since 2 to 3 hours (not talking and not working properly). No urine output since morning on 24-3-22 No history of  burning micturition,  vomiting, loose stools,  SOB,  cough ,chest pain, bleeding manifestations. pERSONAL HISTORY: Diet- mixed Appetite- decreased since 3 days Sleep - indequate Bowel - regular Bladder - decreased urine output on 24-3-22 PAST HISTORY : N/K/C/O DM ,HTN,BA,TB, CVA,CAD, epilepsy ADDICTIONS: Smokes ,montly once and was a occasional drinker but stopped 1 month back. No significant drug history FAMILY HISTORY : not significant GENERAL EXAMINATION :  Patient is oriented to time ,place and person Poorly built and poorly nourished