PX : the rabies is trying to kill her So: natumba ni kirig. nahiwi iya baba. ( She' s having a seizure) ( Her mouth is not allinged) HPI : June 21 she got bitten by a stray cat ( kitten) .there's no signs of .damages She was so anxious that she might have rabies.so her mom took her to the anti rabies .and she already took 2 doses . June 24 at night she experience palpitations, dyspnea, her was hot ( undocumented). Ahe she has headache . She was given a relaxant at the hospital. The were discharged eventually. June 25 The next day they took her to a folk healer She mentioned that she can see 2 girls ( black and ugly) all of a sudden and continuous .they give her commands to kill her and kill others . They also took her to the priest exorcists. July 1 they brought her to the private psychiatrist at dumagate. . Olanzapine 10 once a day Sertraline. 50 once a day In following days she starts to forget few people's name who's around her ..July 4 they called the secretary of the psychiatry. They mentioned that she's sharing her hands involuntarily. They proscribed to take biperiden 2mg 3 times a day July 15 they went to the follow up check up. All throughout this time no changes in appetite and in sleeping behavior.. no fatigue no lowood or no low energy. Oct. 2024 her father died. Past psychiatry histort 2022 - she was diagnosed with severe anxiety disorder. And was prescribed with. Olanzapine and stertraline. For 6 months .. no follow ups were done.. Term eldest among the 3 prenatal vitamins done. At home with midwife. No complaints. 0- 3 Breast milk No illness. 4-10 High grades, loves to studying...shy, no bullying, 2024 She was brought to talamban because she's having anxiety. Before hers father got died. And one more time after the father died PX : the rabies is trying to kill her So: natumba ni kirig. nahiwi iya baba. ( She' s having a seizure) ( Her mouth is not allinged) HPI : June 21 she got bitten by a stray cat ( kitten) .there's no signs of .damages She was so anxious that she might have rabies.so her mom took her to the anti rabies .and she already took 2 doses . June 24 at night she experience palpitations, dyspnea, her was hot ( undocumented). Ahe she has headache . She was given a relaxant at the hospital. The were discharged eventually. June 25 The next day they took her to a folk healer She mentioned that she can see 2 girls ( black and ugly) all of a sudden and continuous .they give her commands to kill her and kill others . They also took her to the priest exorcists. July 1 they brought her to the private psychiatrist at dumagate. . Olanzapine 10 once a day Sertraline. 50 once a day In following days she starts to forget few people's name who's around her ..July 4 they called the secretary of the psychiatry. They mentioned that she's sharing her hands involuntarily. They proscribed to take biperiden 2mg 3 times a day July 15 they went to the follow up check up. All throughout this time no changes in appetite and in sleeping behavior.. no fatigue no lowood or no low energy. Oct. 2024 her father died. Past psychiatry histort 2022 - she was diagnosed with severe anxiety disorder. And was prescribed with. Olanzapine and stertraline. For 6 months .. no follow ups were done.. Term eldest among the 3 prenatal vitamins done. At home with midwife. No complaints. 0- 3 Breast milk No illness. 4-10 High grades, loves to studying...shy, no bullying, 2024 She was brought to talamban because she's having anxiety. Before hers father got died. And one more time after the father died Could u arrange this and order it according to hpi

Here is the HPI arranged in chronological order:

History of Present Illness

Patient's Chief Complaint: "The rabies is trying to kill her." Significant Other's Report: "Natumba ni kirig. Nahiwi iya baba." ("She's having a seizure. Her mouth is not aligned.")

Background / Precipitating Event

June 21, 2026 Patient was bitten by a stray kitten. No visible wound damage noted. Patient became highly anxious about possible rabies infection. Mother brought her to an anti-rabies clinic; 2 doses of anti-rabies vaccine were administered.

Onset of Symptoms

June 24, 2026 (Night) Patient experienced:
  • Palpitations
  • Dyspnea
  • Fever (undocumented temperature)
  • Headache
Brought to a hospital. Given a relaxant. Discharged the same night.
June 25, 2026 Family brought patient to a folk healer, then to a priest/exorcist.
Patient reported visual hallucinations - seeing 2 girls described as "black and ugly," appearing suddenly and continuously, giving her command hallucinations to kill herself and others.

Psychiatric Consultation & Medications

July 1, 2026 Brought to a private psychiatrist (Dumagate). Prescribed:
  • Olanzapine 10 mg once daily
  • Sertraline 50 mg once daily
Following days post-July 1 Patient began forgetting names of people around her (memory impairment noted).
July 4, 2026 Family called the psychiatrist's secretary. Reported involuntary shaking of hands (tremors - likely extrapyramidal side effect of olanzapine). Additional prescription given:
  • Biperiden 2 mg three times daily
July 15, 2026 Follow-up check-up conducted.
Throughout this period (June 24 - July 15):
  • No changes in appetite
  • No changes in sleeping behavior
  • No fatigue
  • No low mood / low energy

Significant Life Event

October 2024 Patient's father passed away. (Note: Chronologically this appears to be a prior-year event; may be a documentation discrepancy - see Past Psychiatric History below.)

Past Psychiatric History

2022
  • Diagnosed with Severe Anxiety Disorder
  • Prescribed Olanzapine and Sertraline for 6 months
  • No follow-up consultations completed
2024
  • Brought to Talamban (likely a psychiatric facility) for anxiety
    • Once before the father's death
    • Once after the father's death

Personal & Developmental History

  • Birth: Term baby, eldest of 3 siblings. Prenatal vitamins taken. Home delivery with midwife. No birth complications.
  • Ages 0-3: Exclusively breastfed. No childhood illnesses noted.
  • Ages 4-10: High academic grades. Loved studying. Described as shy. No history of bullying.

Clinical Note: The timeline of events (June-July listed without a year, father's death in Oct 2024) suggests the acute episode may be occurring in 2025 or 2026, while the father's death and prior psychiatric hospitalizations are historical. This should be clarified during the interview.
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