A 45 yr old male came to OPD with chief complaints of fever since 4 days associated with left sided loin pain . Patient also presented with breathlessness and abdominal fullness since 2 days . HISTORY OF PAST ILLNESS Patient is a plumber by occupation and is apparently asymptomatic 14 yrs back later he was on medication for infertility ( he used both herbal and generic medicine ) for 6 months continuously and as a part of health check up he was diagnosed with Diabetes 10 yrs back . He received treatment for infertility irregularly for about 7 yrs . Patient adopted a girl child 9 yrs back . Patient suffered with loin pain 6 months back for which he was treated by RMP and it was relieved , now since 4 days patient had fever associated with vomitings , chills and rigor. Fever not relived on medication. He also had left lumbar region pain and shortness of breath that relieved on sitting . HISTORY OF PAST ILLNESS Patient is a K/c/o DM Not a k/c/o a...