A 62-year-old-male patient present with c/c chills and rigor without fever usually at upper back and usually during night time from last 5 days h/o of mild intermittent fever 7days ago h/o loss of appetite no history of joint pain, no h/o burning micturition on examination b/l chest clear xray normal, cbc wnl, obc, pbf malaria negative lft and kft wnl. no past h/o dm, ht