I am working as a GP in a polyclinic situated in Jubail,KSA.Most of the patients attending here have a place with low financial status. I am discussing a case of cellulitis which fits the course of module and an incessant conference when all is said in done practice. I picked this case since cellulitis , as I would see it, shows a few difficulties as far as differential diagnosis and fitting treatment. My point in doing this contextual case study would be to basically assess my management of cellulitis and draw some learning focuses. The case is of cellulitis of the legs, which is the one we see all the more much of the time in primary care.
DK,a 34 years old male presented to me for the first time with one week history of rapidly growing erythema on his right lower leg.It was painful with minimal swelling. His primary presenting symptoms were fever and malaise, and was taking Paracetamol 500mg twice daily, following consultation with a local camp physician 3 days ago, with negligible effect. He reported the same episode nearly two years back which resolved completely after treatment with anti-biotics(A/B). Apart from this there was no significant medical history. He was a smoker and used alcohol occasionally. He works as a supervisor in a local company which involved outdoor activities the most of the time. He was supervising a critical project and was stressed as he was not able to attend his work for the past 3
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My patient had a strong risk factor of previous episode,which was not modifiable. Unfortunately, I didn’t ask for chronic edema ,as this is also a vital risk factor.The clinical picture semed to fit most closely with that of a cellulitis.Generally, the cases of cellulitis are not as straight forward as this case was. Aforementioned differential diagnoses should be excluded cautiously. The most common misdiagnoses include the
Section 1: Identification of the unknown pathogen Patient is Terrance V. Haller, a 13-year-old male who enjoys outdoor activities such as skateboarding. No previous medical history and there are no known allergies. Terrance had a skateboarding accident where there were multiple lacerations and contusions. The wound on his forearm extending to his elbow was slow healing and therefore became pus producing. The patient has since returned to his primary care physician to find out what is going on.
He is in no acute distress. Blood pressure 120/78. Pulse 70 and regular. Weight 177 pounds. Height 5 '6".
ELATED CASES: None. SUPPORT DOCUMENTS: None. On 12/15/2015, Christie Hardie contacted Pasco Sheriff`s Office by telephone to report a Petit Theft. Ms. Hardie advised between 1700 and 1730 hours on 12/14/2015, an unknown suspect stole her white and black Hello Kitty wallet, with contents out of her open purse that was sitting in the child seat section of a shopping cart.
A rash for dermatomyositis can be a violet-colored or dusty red rash that appears most commonly on a person’s face or eyelids, but it can also be found around a person’s nails, knuckles, elbows, back, chest and knees. Most of the time the first visual sign of dermatomyositis is a patchy bluish-purplish rash. Another sign of dermatomyositis is the progressive weakening of the muscles closest to the trunk of the body, such as: the hips, thighs, shoulders, upper arms, and neck. Over time this pain will gradually worsen, so the weakness will affect both the right and left sides of the
It began with “swellings in the groin and armpit, then eventually spread across the whole body.” Then “dark
He was wandering in the desert for 2 months, and disoriented to time, although; he continued to call his daughter’s name, and asked for his wife. He had a number of bruises on his face, and his toes on his right foot were black, in fact the toes fell off. The doctor’s had to auto transplant his kidney, except his BP dropped and the man experienced cardiac arrest. Then they ordered an Echocardiogram, which this disturbed Dr. Pierce, for she suggested that it be done first.
Identifying Chronic Wounds There are basically two types of wounds that a person can get. The first type is an acute wound. It is generally minor and heals fairly quickly. The second type is a chronic wound, and it is more concerning because it is extremely painful, and it generally doesn 't heal, even after several months have passed by. These wounds have varying symptoms due depending on the type of chronic wound that it is.
165 reports were used, of those the study determined that 114 were acutal medication errors and 51 potential
The Art of Diagnosing: The Implications of Deliberate Misdiagnosis The misdiagnosis of a patient is an occurrence that happens quite frequently within clinical practice for various reasons. Many times these misdiagnoses are due to unintentional errors. However, there are times when practitioners intentionally misdiagnosis patients (Kirk and Kutchins, 1988). Deliberate acts of misdiagnosis exist that are universally viewed as being unethical such as blatant use of fraud or abuse. However, there are forms of deliberate misdiagnosis that are viewed less objectively, and are often justified as being in the best interest of the client.
The Joint Commission determines the highest priority patient safety issues and how best to address them (The Joint Commission, 2016). Treatment issues and errors have been a focus of the Joint Commission however the errors in diagnosis leading to inaccurate treatments have not been of serious concern to be placed on the dockets (Berenson et al., 2014). The Society to Improve Diagnosis in Medicine and the Institute of Medicine are examining this problem. It is currently made up of mostly physicians and other healthcare professionals.
The emergency room physician, David C. Lee, M.D., ordered medication, a series of diagnostic tests, and blood cultures, and he admitted Mrs. Adae to the hospital for further observation and testing, in order to rule out myocardial infarction and ACS. Dr. Lee listed "infectious etiology" in his differential diagnoses. Jennifer Bain, M.D., came on duty as an attending physician during the morning of June 29, 2006. Dr. Bain, an employee of UC, recorded her suspicion that Mrs. Adae 's chest pain was musculoskeletal. Dr. Bain noted that Mrs. Adae 's EKG, cardiac enzymes, and blood tests, with the exception of her elevated blood sugar, were normal.
The patient was diagnosed for polyps and multiple diverticula at the age of 68. The Patient suffers of painful osteoarthritis of both knees, shoulder hips. Patient?s mother deceased at the age of 79 from breast cancer and her father deceased at the age of 54 from heart attack. The patient noted with bilateral lower extremities edema, and claimed that she uses 2 pillows as a comfortable position to sleep,
The patient is a 51-year-old female with a past medical history of uncontrolled diabetes mellitus type II (as evidenced by A1C), hypertension, and morbid obesity to 385 pounds. The patient presented to the ED with right groin pain, fever, chills, altered mental status, and severe hyperglycemia to 648. Upon examination, patient was found to have -- and imaging confirmed -- a necrotizing soft tissue infection of the perineum extending to the groin involving the genitalia and lower abdomen, and was in septic shock. The patient was admitted for emergent surgical debridement. Approximately 1400 square centimeters of necrotic right groin tissue tracking inferior to the right labia majora and abdominal wall was excised. On day two post admission,
Introduction Medical science has come a long way in the last century and half, from being predominantly based on the subjective skills that were guided by the intuitive capacity of the physician, called ‘clinical acumen’ in common parlance, to a greater reliance on the ever expanding repertoire of diagnostic tools which add an objective component to the process of identifying health problems and handling them. This had lead to the myriad use of these diagnostic techniques, which have time and again been proven to be of utmost value in specific case diagnosis, their efficacy ratified by epidemiological research. So now the physician is encouraged to call upon the services of the wide array of investigation tools in order that his/her case identification is as precise as possible with current available techniques. Though this augurs well for the science of identification of health problems, it has lead to a lot of infrastructural problems.
In Home Care and Inflammation Inflammation often gets a bad rap. Many people associate inflammation with pain, disease, and sickness. In reality, inflammation is the response to the body fighting to stay healthy. The issue many seniors face is chronic inflammation or autoimmune disorders. In these cases, the body remains in a constant state of inflammation or becomes inflamed when the body mistakenly fights against itself.