1. Tell the patients story
FR is a 67 year old woman with chronic lower extremity edema and right lower extremity cellulitis, who has been managed with ciproflaxin, having failed outpatient treatment. Now is admitted for antibiotics and wound care after presenting to clinic on day of admission. The patient also has been complaining of poor p.o. intake for the last week or so due to poor appetite and some chills. Also notes some falls, 2 times in the last week or so. Several days prior to admit, had a fall while trying to have a bowel movement, which resulted in incontinence. While running to the bathroom, she slipped and fell on a stool, hit her head on the toilet, and passed out as a result. She did not present to medical care at that time, but in the ED during this presentation she had a normal CAT scan of her abdomen. Chest x-ray was also normal. Vitals were unremarkable, without any evidence of SIRS physiology. Prior cultures grew MSSA resistant to clindamycin, levo, penicillin, and pseudomonas pan sensitive.
The patient has multiple allergies, however mainly to Clindamycin, Doxy, Minocycline, Penicillin, and SULFA.
The patient denies any chest pain, shortness of breath, any new neurologic complaints. No nausea, no vomiting, no dysuria, no
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Cellulitis is an infection that also involves the skin's deeper layers: the dermis and subcutaneous tissue. The main bacteria responsible for cellulitis are Streptococcus and Staphylococcus ("staph"). MRSA (methicillin-resistant Staph aureus) can also cause cellulitis. Sometimes, other bacteria (for example, Haemophilus influenzae, Pneumococcus, and Clostridium species) may cause cellulitis as well. Cellulitis is fairly common and affects people of all races and ages. Men and women appear to be equally affected. Although cellulitis can occur in people of any age, it is most common in middle-aged and elderly
Addie acquired Stenotrophomonas bacterial infection in the hospital. She acquired it from the tubes of the lung bypass machine ECMO which doctors used to try and support her respiration after her
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
The patient is a 16-year-old high school student who is referred to "through not any gastrointestinal problems. Vomiting occurs as a result of the nausea. This has been going for about 3 1/2 years."
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Even though S. aureus is mainly associated with food poisoning, the bacterium can penetrate the skin or other mucous membranes to invade a range of tissues which will cause a variety of infections. Superficial infection of the skin can cause boils, impetigo, styes (infection of the glands or hair follicles of the eyelids), folliculitis, and furnacles. All of these infections are charac...
Necrotizing fasciitis, known commonly known as "flesh eating bacteria [infection]", occurs in a wide range of people 1. It occurs in the elderly, middle aged and younger patients. It occurs in athletes and debilitated individuals. It can occur in drug abusers with self inflicted wounds and healthy individuals with incidental injuries. It may occur in those with metabolic disorders such as diabetes and those with suppressed immune systems. It may occur in those with no underlying disorders and no known particular injury. It occurs under ordinary circumstances such as a seemingly harmless cut or scrape and in wounds resulting from major trauma such as an auto accident.
Patient: is a 55-year-old male, came into the hospital confused and incontinent, stated he had pain in his abdomen but could not state where exactly, pointed to the whole abdomen. Patient lives at home with a friend in an apartment that had beer bottles all over his apartment. Patient drinks 24 beers a day and smokes a pack a day. Blood tests were done when patient was admitted into the hospital: ammonia levels were high (79), Hemoglobin was low (105), Platelet count low (113), Magnesium normal (0.60), Potassium normal (4.9), Sodium normal (141), urea normal (4.0), ALT high (76), leukocytes high (8.1)
Bratton, R. L., Whiteside, J. W., Hovan, M. J., Engle, R. L., Edwards, F. D. (2008). Diagnosis
Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis inflames and swells, causing the airway to become blocked (Mayo Clinic, 2018). The epiglottis is leaf-shape flap of cartilage located in the throat behind the tongue and in front of the larynx. It is made of yellow elastic cartilage tissue, lined with a mucous membrane. The epiglottis is usually resting in the upright position which allows an opening in the trachea for air to pass through (Heller & Zieve 2017). But when a person is eating and swallowing the epiglottis folds over so that the trachea becomes blocked off and that way no food or water enters the trachea and instead goes through the esophagus. The epiglottis is able
Streptococcus pyogenes is a very common bacteria found in humans. It is very transmissible and can be caught through the air via coughing or sneezing. This form of Strep. illness is referred to as Streptococcal pharyngitis, also known as Strep. throat, which can complicate into Scarlet Fever. It is also possible to be infected through abrasions of the skin, which can result in cellulitis, impetigo, or even necrotizing fasciitis. Aside from human to human contact, these bacteria can also be found in unpasteurized milk. There is no vaccine for Streptococcal infections, though antibiotics such as penicillin still work very well against them.
In the documentary, Hunting the Nightmare Bacteria, reporter David Hoffman investigates this new untreatable infection along two individuals and a bacterial virus within a hospital. The first individual Hoffman investigates is Addie Rerecich of Arizona, she was treated for a staph infection with antibiotics, but other complications arise. Addie had a lung transplant, she was given several different antibiotics, but her body became pan-bacteria, non-resistance to the bacteria. Addie’s life was on the edge, she had to be on life support, and finally she received new lungs. The transplant helped Addie but it would take years before could go back to normal before the infection. The second individual is David Ricci; he had his leg amputated in India after a train accident. The antibiotic treatment he received became toxic to his body increasing problems. While in India, he underwent surgery almost every day because of infections he was developing. Back in Seattle, doctors found the NDM-1 resistance gene in his body; NDM-1 gene is resistance to almost all antib...
CASE DESCRIPTION: 62 y.o. male with h/o ESRD currently on dialysis, DM II, known coronary artery disease s/p CABG x 3(6 years ago) presented to the ER with complaints of lower abdominal pain started one day before presentation associated with mild nausea but denies any episodes of vomiting. He describes pain is located in lower abdomen with no radiation and no aggravating or relieving factors. Prior to this presentation he was seen at a different ER with similar presentation around 12 hours ago and was discharged to home with a diagnosis of constipation. After using laxatives and having bowel movement as the pain was not subsiding and he came to St Vincent. Physical examination was unremarkable with the exception of tenderness to palpation in lower
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.