Differential Diagnosis Exercise ( Dde )

Differential Diagnosis Exercise ( Dde )
10/5/2014 Creighton University College of Nursing Differential Diagnosis Exercise (DDE) Name: Mary M. McAuliffe Clinical Sign or Presenting
Problem : Fever A. Identify appropriate history questions to be asked of the patient, nursing staff, or family in order to discriminate critical
characteristics or attributes about the presenting problem. HPI Onset: When did you first notice the fever? Where were you when you first began
having the symptoms? Location: Not applicable Duration: Is the fever constant or does it come and go? When is it worst? Have you noticed a pattern
to the fevers? When is it the highest? When is it the lowest? Characteristics: How high has your fever gotten? How long does it last? Associated
Symptoms: Are you... Show more content on Helpwriting.net ...
ALLERGIES: Thorough review of all medication, food, and environmental allergies is necessary. MEDICATIONS: Any use of diuretics, pain
medications, antiarrhythmic agents, anti–seizure drugs, sedatives, antibiotics, antihistamines, barbiturates, cephalosporins, salicylates, and
sulfonamides?(Ross & Basello, 2003) FAMILY HX: Family history of chronic leukemia, lymphomas, renal cell carcinomas or metastatic cancers
(Ross & Basello, 2003) Any family history of immunocompromise? SOCIAL HX: Any recent travel? If so, where to and for what duration of time?
Causes (if recent travel to distant countries) may include Malaria, Viral Hepatitis, Diarrheal disorders, or Typhoid fever (Merck's Manual, 2014). If
recent travel around U.S., causes may include tick exposure (rickettsiosis, Lyme's disease), mosquito exposure (arboviral encephalitis), wild animal
exposure (rabies), fleas (plague), cat–scratch disease or toxoplasmosis, reptiles (salmonella), or bats (rabies) (Merck's Manual, 2014). Any drug use?
Drugs that can cause increased heat production include amphetamines, cocaine, ecstasy, and anesthetics (Merck's Manuals, 2014). ROS Constitutional:
overall health status including physical, mental, and functional health (ADL's, etc), recent weight loss or weight gain, fever, chills, repeated infections
HEENT: headache, ear pain, runny nose, sore throat, neck pain or stiffness Cardiovascular: chest pain
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Analgesima Essay
Analgesics
Pain control is essential to quality patient care. Otitis externa can be quite painful, and patients frequently request analgesics. These agents ensure
patient comfort and may have sedating properties. Inexpensive, simple non steroidal anti–inflammatory drugs (NSAIDs) reduce inflammation and
irritation and can be paired with opiates to improve pain symptoms. In some cases, systemic analgesics are helpful before ear cleaning or wick
placement (27,20).
Oral and intravenous antibiotics
Most persons with OE do not require oral medications. Oral antibiotics are generally reserved for patients with fever, immunosuppression, diabetes,
adenopathy, or an infection extending outside the ear canal. They should be given to individuals with ... Show more content on Helpwriting.net ...
Occasionally an abscess forms in the ear canal; this usually occurs in cases of OE caused by S. aureus (6). Treatment of the abscess is often
accomplished by means of a simple incision and drainage procedure using a needle or a small blade.
Long term monitoring
For a patient of OE with debris, a suctioning of the EAC on a weekly basis is required until debris has been removed. Patients must be monitored to
ensure complete resolution of OE. Even in mild cases, follow–up is important for evaluating the response to treatment. A follow–up visit 1 week after
starting treatment is usually adequate (3).
(d) Prognosis
Most incidents of OE resolve without difficulty. The majority of patients improve within 48–72 hours of antibiotic administration. Failure to improve
within 2–3 days should call the diagnosis into question and prompt the physician to reevaluate the patient. Otitis externa usually resolves fully in 7–10
days (3). Resolution of eczematoid OE occurs with control of the primary skin condition. In some patients, OE can cause severe otalgia necessitating
administration of narcotic pain relievers. Pain usually improves 2–5 days after initiating therapy (27). Temporary hearing loss is common secondary to
canal occlusion. Severe infections may cause cellulitis or lymphadenitis of the face or neck. If left untreated, the infection may invade the deeper
adjacent structures and progress to necrotizing (malignant)

Our patient was admitted to the ICU with respiratory...
Our patient was admitted to the ICU with respiratory distress. Respiratory distress is caused by an inflammation due to neutrophil activation. The body
has an inability to transfer oxygen or carbon dioxide. This leads to increased permeability of A–C membrane, which then causes edema. Because of the
edema, there is an increase in fluid in the peripheral areas and edema in hands, feet, and the scrotum. Decreased gas exchange also occurs because of
the edema and mechanical ventilation is then implemented. The ventilator settings for our patient were: Rate 15, Peep 12, Peak Flow 60, FiO2 95,
Flow Trig 1. Respiratory distress can also lead to multi organ failure if not treated; however, our patient's respiratory distress resulted in... Show more
content on Helpwriting.net ...
Two mechanisms, insulin resistance and decreased insulin secretion, are vital functions that lead to the development of Type 2 Diabetes. Insulin
resistance is the effect that insulin has on insulin–sensitive tissues and their response to the insulin (McCance and Huether, 2010). Abnormality of the
insulin molecule, high amounts of insulin antagonists, down–regulation of the insulin receptors, decreased/abnormal activation of postreceptor kinases,
and alteration of glucose transporter proteins all lead to defects of the insulin molecule itself (McCance and Huether, 2010). Because the patient is
obese, he is at risk for hyperinsulinemia and decreased insulin receptor density. When compensatory hyperinsulinemia occurs, the client may not begin
to see the manifestations of Type 2 Diabetes for several years (McCance and Huether, 2010).
Beta cells eventually undergo an apoptotic cell death. "Beta cell 'exhaustion' from increased demand for insulin biosynthesis, associated with
intracellular oxidative stress and endoplasmic reticulum dysfunction, also has been implicated in beta cell apoptosis" (McCance and Huether, 2010).
Four hormones/peptides influence the development of Type 2 Diabetes Mellitus. They are: glucagon, amylin, incretins, and ghrelin. The primary
function of glucagon is to increase blood glucose levels. Glucagon stimulates both glycogenolysis and gluconeogenesis, and does this in the liver
(McCance and Huether, 2010).

My Second Week Of Placement Essay
Description:
During my second week of placement, I was working under the supervision of my preceptor, caring for a fifty four year old Samoan gentlemen,
Mr.Li (pseudonym). When we went to his place in Mt. Albert at around 11am, he was sitting on the chair and his wife was sitting beside him. Mr
Li had left leg ulcer and he developed this in February 2016, when he went to Samoa. According to Mr. Li, it started off with a blister and lead to left
leg cellulitis. Mrs.Li (pseudonym) told us that when Mr.Li went for swimming in the beach during his stay in Samoa and he knocked his left big toe.
Mr.Li 's big left toe got infected and doctor's informed them, this is how his left leg cellulitis started.
Mr. Li has multiple medical problems such as insulin dependent diabetes, hypertension, gout and retinopathy. Mr.Li had a couple of hospital
admission due to his left leg cellulitis. He mentioned that during his hospitalisation his blood pressure was on higher side. Mr Li is on medication for
his hypertension. He is on amlodipine and cilazapril. To control his BSL (blood sugar level) he is on insulin and metformin. On our first visit Mr.Li
was not showing any insight about his medical conditions. He seemed less interested of what's going on with his leg. Although he had poor insight,
we did advise him about his health, especially to regularly monitor his blood sugar level and blood pressure. Mr.Li had no records of his BSL readings.
On the second day we visited him again. On

Cellulitis Essay
Description
Main purpose of cellulitis treatment process is reduction of severity cellulitis infection, fast recovery, pain relieve, cure affected skin and prevention of
recurrence – definition of treatment for cellulitis. In most cases healing process contains treatment with antibiotics drugs. Antibiotics are used orally or
intravenous depending of severity of affected skin area. Period for using oral antibiotics (by mouth) is 10 to 14 days. In this period is crucial to take
every single pill that doctor has prescribed, even later when you begin feel better .Treatment for cellulitis with intravenously antibiotics (IV) is
recommended when we have more serious infection,in most cases lasts 3 to 5 days.
Generally,skin and any ... Show more content on Helpwriting.net ...
All this instructions of self–care cellulitis treatment are in order to help ease symptoms and speed up recovery.
Upon healing, the infected skin showing signs of cellulitis will begin to regenerate and the blistered areas will flake off like old skin.
Terrasil MAX is a reparative skin cream used to treat various types of skin problems. It is fast–working and can provide instant relief from itching,
irritation, inflammation and soreness. With regular use, Terrasil MAX cleans, soothes, moisturizes and repairs unhealthy skin. It's formulated with
plant extracts and minerals which fight germs and enhance the skin's regenerative process.
This innovative lotion contains no harsh chemicals, steroids or parabens. Made from only natural ingredients, Terrasil MAX is safe to apply on
sensitive skin, and people of all ages and skin types can use it. There are no known side effects associated with the use of Terrasil MAX over a five
year range. Thousands of customers around the world recommend this therapeutic cream for numerous skin issues.
B)Medical Treatment For Cellulitis Infection
B.1.) Home Care Medical Treatment For Cellulitis
If infection is not too serious you can be treated at household. Your medical adviser will give you a prescription for antibiotics to take orally for a 7 to
10 days. Be sure to tell your doctor about any responses you may have had previously to

Cellulitis And Abscesses Essay
Cellulitis and Abscesses
Rationale
The patient is a 59–year–old female presented with an abscess and cellulitis located above and slightly to the left of her gluteal cleft. She reports pain
at the site of the infection, swelling and redness is also noted. The patient underwent an incision and drainage (I&D) and was put on Vancomycin to
treat the infection. She has a history of HTN, CAD, and hyperlipidemia, however no history of diabetes, cancer, or autoimmune disorders that are
linked to increase the risk for abscesses were reported. The fact that this is the first time in which she has had an abscess or cellulitis leads me to believe
the patient would highly benefit from being educated on these overlapping skin infections.
Outcomes & Teaching... Show more content on Helpwriting.net ...
Like with cellulitis, a penetrating injury to the skin can also cause an abscess, as can clogged oil and sweat glands, infected hair follicles, and
osteomyelitis (Misty, 2013). Although anyone can get an abscess or cellulitis, many conditions are conditions are known increase the risk of cellulitis
and abscesses. Some common conditions know to increase this risk include, but are not limited to, viral, fungal, or bacterial skin infections such as
athletes foot, a history of dermatitis, diabetes, eczema, obesity, smoking, edema, immunosuppression, and cancer (Raff & Kroshinsky, 2016). In
regards to the risk factors of cellulitis and abscess formation there are many health–care related activities that can be implemented to help prevent these
infections from occurring. Eating healthy is a good start, it can help an obese individual lose weight as well as control many underlying disorders,
such as diabetes, that may influence infections. Avoiding any scraps or cuts on your skin, but cleaning them thoroughly when they do occur will help
keep the bacteria that causes infections out of the skin. Cleaning your skin regularly will also help to prevent pores, glands or hair follicles from
clogging. These methods alone do not guarantee the prevention of abscesses or cellulitis, but taking care of

Gouty Arthritis
Gouty arthritis, hypertension, hyperlipidemia and left ventricular hypertrophy are the main diagnosis. American College of Rheumatology diagnostic
criteria for gout is the presence of urate crystals in the joint fluid (Hainer et al., 2014). Monosodium urate crystals are seen under a polarizing light
microscope which confirms the diagnosis of gout. Furthermore, the most commonly affected area is the first metatarsophalangeal joint. Other common
sites are mid–tarsal joints, ankles, knees, fingers, wrists and elbows. Also, gout appears to be red and swellon in the affected joint (Saccamano, 2015).
Similarly, patient had left knee pain with redness and swelling. Hypertension is diagnosed by the systolic blood pressure в‰Ґ 140mmg Hg or the
diastolic ... Show more content on Helpwriting.net ...
I should have ordered gram stain and culture of synovial fluid to rule out septic arthritis (Pujalte, 2015). Even though monosodium urate crystals are
found, it is important to order gram staining and culture of synovial fluid because gout and septic arthritis can coexist (Saccamano, 2015). It is less
likely to be rheumatoid arthritis because of negative RF factor, negative ANA, absence of joint stiffness and symptoms are unilateral (Pujalte &
Albano–Aluquin, 2015). Rheumatoid arthritis has a symmetrical presentation. It could be cellulitis because of the presence of warm, tender, swollen
and tenderness in the left knee. Cellulitis can be both sudden or gradual (Baddour, 2015). Also, symptoms worsen and erythema expand over the
course of hours or day. Hence, gradual worsening of signs and symptoms with the treatment of gout point towards cellulitis. It is not pseudogout
because of the absence of calcium pyrophosphate crystals and elevated uric acid level (Hainer et al., 2014). The patient with pseudogout can have
symptoms similar to gout and respond to NSAIDS (nonsteroidal anti–inflammatory drugs). I did not consider trauma as one of the differential diagnosis
but, DXR recommended to consider one. I agree because sudden onset of pain could be the cause of trauma or injury. Since patient smokes pack a
day and has been smoking for the last 30 years, I should have considered nicotine dependency as my additional

Staph Infections Research Paper
Different Types Of Diseases Caused By Staphylococcus Aureus
Abigail Ivic
Gateway Technical College
Staphylococcus Aureus is a bacteria formed in a group. It is more commonly referred to as staph infections, ( pronounced staff ). Staph infections can
be mild to severe in nature, and if left untreated can be fatal. They can be treated with different medications depending on the type of infection. Topical,
oral, or intravenous medications can be used. There are many different types of staph infections to include, MRSA (methacillin resistant staphylococcus
aureus), pneumonia and cellulitis. This paper will target how staph infections effect adult subjects.
Firstly, MRSA (methacillin resistant staphylococcus aureus), is a more

My Patient Is A 68 Year Old Indian Male Essay
My patient is a 68–year–old Indian male. His health issues include hypertension, Type 2 diabetes, hyperlipidemia, cellulitis, and insomnia. He has
been in the facility for 3 years. My patient's weight is 156 lbs. and there were no major weight changes for the time he has been in the facility. My
patient needs assistance with either wheelchair or a walker, is able to ambulate with or without a device. He is not allergic to anything, therefore, no
modification to the medication is needed. The primary the patient is in the facility is because of a foot ulcer. The foot ulcer is unable to heal at a
normal pace because he has diabetes. My patient did not take any medication prior to admission to the facility. One of the diagnosis included
hypertension also known as high blood pressure. If not treated over time hypertension can cause heart disease and stroke. In order, to lower blood
pressure a person can consume a healthy diet with less salt, exercise daily and take their medication. Usually, if a person's blood pressure is above
140/90 mmHg they are considered to have high blood pressure. My patient takes Lisinopril, it decreases blood pressure in hypertension, decrease
preload, and afterload in cognitive heart failure. The only use for this is when a person has mild to moderate hypertension. Precautions for those who
should not take this if you are pregnant, breastfeeding, or have renal disease. An adult can take this by mouth 10–40 mg/day and may be increased to 80

Cellulitis Research Paper
Cellulitis is a skin disease that affects more than three million people in the United States every year. It requires a medical diagnosis but can be treated
by medical professionals. This disease may spread rapidly but can be resolved within a few days to a few weeks.
Causes and Symptoms Cellulitis is caused by bacteria, mainly streptococcus or staphylococcus aureus getting into the body by a break in the skin. It
has fairly clear symptoms and signs. Symptoms to looks for are redness, tenderness, swelling, and warmth, chills, fever, and swelling caused by fluid
buildup called edema in the affected area (MedicineNet). Many times it appears in areas where skin broke open such are surgical wounds or ulcers.
The skin on lower legs is the ... Show more content on Helpwriting.net ...
If there cannot be a clinical diagnosis, labs or imaging can be taken to help with the process. Blood cultures are only used in extreme cases and
imaging is mainly used to rule out other diseases. Cellulitis is not contagious and can usual treatment consists of oral antibiotics. In the most severe
cases, the infection may be managed in clinics, infusions centers, and emergency departments using IV antibiotics before the patient is stable enough
to take the oral medication (Bartlett). One way to help with the pain is to elevate the affected areas and apply cool, wet, and sterile bandages. In some
extreme cases, surgery has been needed to drain the infected tissue (UMMC).
Prevention
Cellulitis can be prevented in most cases. Some precautions when there is a skin wound are to: wash the wound with soap and water daily, apply
protective cream, cover it with a bandage, and watch for any signs of infection. For people with poor circulation or diabetes: inspect feet, moisturize
regularly, tims nails carefully, protects hands and feet, and treat and superficial infections on the skin's surface immediately (Mayo). If a disease can be
prevented, it is important to take those steps to prevention.
Alternative

Cellulitis Treatment
The Treatment of Cellulitis Cellulitis is a common skin and soft tissue infection with 2.2% of ambulatory visits and an incident rate of 24.6 per 1000
persons (Khawcharoenporn & Tice, 2010). Cellulitis is potentially serious and is one of the common reasons people go to the emergency room and
require admission to the hospital (Aboltins, 2015). The purpose of this review is to explore the current treatment of cellulitis. This paper will address:
different medication treatments, mode of administration, failure factors, variability in prescribing, home therapy and preventing recurrence of
cellulitis. The outcome of this literature review is geared toward education on the treatment of cellulitis with intentions to use in future practice.
Method ... Show more content on Helpwriting.net ...
With drug resistance on the rise it is important to continue to search for new way to treat gram–postive pathogens. Mason, et al., (2014), focused on
assessing the efficacy and safety of intravenous to oral tedizolid for treatment of patients with acute bacterial skin infections. This trial was conducted
from Sept. 28, 2011 to January 10, 2013 in Argentina, Australia, Germany, New Zealand, Poland, Russia, South Africa, Spain, and the USA. Patients
had to at least 12 years old, suspected or confirmed gram–positive pathogen (Moran, et al., 2014). There were 666 patients involved in the study 332
taking tedizolid 200mg for 6 days and 334 taking linezolide 600mg twice a day for 10 days. Both treatment groups had achieved early clinical
response (Moran, et al., 2014). The limitation with this study is the potential for unreliable lesion measurements as this was done

Staphylococcus Aureus, Or Mrsa
Methicillin–resistant staphylococcus aureus, or MRSA is a possibly fatal strain of Staph aureus that is resistant to many antibiotics. MRSA is unable
to be killed by all beta–lactam antibiotics. This includes all penicillin's and cephalosporin's. There are two known type of MRSA. The most common
type is nosocomial MRSA or HA–MRSA. Which is a strain found in hospitals, nursing homes, ect. The second type is community acquired MRSA or
CA–MRSA. This strain of MRSA infects individuals who have not been in a hospital setting and are typically quite healthy (Minnesota Department of
Health). With each type there are differences and the ways they are transmitted. When it comes to the nosocomial MRSA hospitalized patients are at
higher risk for becoming infected. Many hospitalized patients have IVs, catheters, and surgical openings that make them very susceptible to becoming
infected. The bacteria can enter into underlying tissue and it becomes very easy for the patients to become infected. Also, quite a few patients are
taking some sort of antibiotic and this reduces the natural flora of the body and that makes it easy for the bacteria to enter the body and cause an
infection. Some of the signs and symptoms of patients with HA–MRSA includes: abscesses, cellulitis, or other skin and soft tissue infections. Most of
the abscesses are filled with pus, red–swollen area surrounding it, and also may be warm to the touch (Minnesota Department of Health). The abscess
is usually very

Cellulitis Case Study Essay
Cellulitis could be defined as an infection of the skin and tissues beneath the skin. It affects the deeper and outer layer of the skin. The causative
organisms could be staphylococcus and streptococcus or methicillin –resistant staphylococcus area (MRSA) or could be as a result of other types of
bacteria like pneumococcus or clostridium. (Medicinenet.com). Based on the given objective and subjective data, Ms. G. has a non–purulent cellulitis
with the following cardinal signs and symptoms; pain, swelling, erythema and warmth. She has severe cellulitis which requires blood culture to be
done in order to know the baseline renal function and the type of antibiotics she will need to be taking. Her case also requires a wound culture to isolate
... Show more content on Helpwriting.net ...
G's, based on the Anatomy Resource Center (ARC). Subjective data are what the patient says relating to the way he or she feels, while objective
data are information gathered from examining the patient physically, and diagnostic testing. (Timby T.K., and Smith, N.E. 2008.). The laboratory
values in this case will help confirm the result which could not be evaluated by objective or subjective data, and helps in the arrival of a nursing
diagnosis and consequently formulate a care plan. Ms. G. is 160cm and 83.7kg has a history of Diabetes. Obesity could hinder tissue perfusion
which will lead to reduced wound healing. Moreover, Malnutrition could be a factor to decrease wound healing due to the fact that she lives alone
in the house and has nobody to help her prepare her meals. She will lack adequate supply of protein, fats and carbohydrate critical for healing of
wound. Medication and not being able to manage her wounds could also be a factor delaying the healing of her wound as she has been in bed for three
days and leaves by

Case Study Of Cellulitis
outcome measured the proportion of patients that had a repeat of cellulitis during the drug phase and follow–up phase (Thomas et al., 2013).
The results of this experiment showed some interesting information. In the end 136 patients were put into the penicillin group and 138 patients were
put into the placebo group. From these patients 15 (5%) took back consent or couldn't be found, 11 died (4%) and 206 (75%) were put into a
secondary care (Thomas et al., 2013). In total 247 (90%) of the patients did the minimum of 18 months of follow–ups and 214 (78%) said that they took
at least 75% of the tablets between the two groups (Thomas et al., 2013). During the trial, the primary outcome saw that it took a median of about 626
days in the ... Show more content on Helpwriting.net ...
Antoher group was given clarithromycin and hydroxychloroquine mix 500 mg and 200 mg respectively twice daily (Berende et al., 2016). And the
other patients got placebos twice daily (Berende et al., 2016). Everyone was blindly assigned.
At the end of the study 205 patients (73.2%) reported a minimum of one adverse effect, like diarrhea or nausea (Table 2) (Berende et al., 2016). Nine
people had a serious adverse effect and 19 had a bad enough side effect that they discontinued with the study (Table 2) (Berende et al., 2016). In the end
though most of the patients made it throughout the whole study.
To measure results the researchers used a 36–question questionnaire at the beginning at the end of the treatment of the 14 weeks, at 26 weeks, at 40
weeks, and finally 52 weeks after treatment (Berende et al., 2016). From the results 252(90%) of the patients completed the study. 76 out of 86 for the
doxycycline, 64 out of 96 for the clarithromycin–hydroxychloroquine and 92 out of 98 patients finished from the placebo group (Berende et al., 2016).
At the end of the study the results showed some interesting results. By looking at the questionnaire mean all the patients quality of life increased from
the original of 31.8 to 36.4 at the end of the treatment. Even though the scores were higher at the end of the treatment there was no significant
difference in any of the groups that were studied

Different Types Of Staph Infections
Abstract
Staphylococcus aureus is a gram positive bacterium. It is accountable for numerous conditions when it crosses the threshold into the human body. The
bacterium may also be referred to as a 'Staph infection'. There are more than 28 different types of staphylococcus aureus that are responsible for
cellulitis, blood poisoning, and various others. Methicillin resistant Staphylococcus aureus is also a type of staphylococcus aureus. Staph infections are
curable with different antibiotics. Staphylococcus aureus
Staphylococcus aureus is a microorganism that appears on several diverse surfaces. This bacterium lives harmlessly on the skin as part of the normal
flora. Hard surfaces are also covered in S. aureus. The microorganism is gram positive. ... Show more content on Helpwriting.net ...
"Staph infections can spread from person to person in group living situations (like college dorms). Usually this happens when people with skin
infections share personal things like bed linens, towels, or clothing. Warm, humid environments can contribute to staph infections" (Staph, 2016).
Infections from the staph families are especially common in teens and young adults due to the amount of sharing and touching this age group do. It is
important to educate adolescents about the damage that a staph infection can have on the body. Americans should also be diligent about having good
hygiene in order to reduce the chance of getting an infection.
The staph infections can range from somber to flesh–eating infections. A common skin condition that staph is able to cause is cellulitis. It is more
common in people who have a weakened immune system such as people who are immunocompromised, infants, and the elderly. Cellulitis is
characterized by a red, warm patch on the skin paired with a fever. "The bacteria that cause cellulitis can spread rapidly, entering lymph nodes and
your bloodstream. Recurrent episodes of cellulitis may cause chronic swelling of the affected limb" (Mayo, 2015). Cellulitis is spread extremely
easily, and is a big issue within long term care facilities. The infection can be cured by antibiotics. However, there are cases reported stating that
cellulitis is becoming resistant to some antibiotics. The doctor can order a culture to send to pathology.

Preseptal Cellulitis Research Papers
Preseptal Cellulitis
Preseptal cellulitis is a common infection that can affect the eyelid and the soft tissues or skin that surround your eye. The infection may also affect the
structures that produce and drain your tears. It does not affect your eye itself.
CAUSES
Preseptal cellulitis may be caused by:
Bacterial infection.
Long–term (chronic) sinus infections.
An object (foreign body) that is stuck behind your eye.
An injury that:
в—‹ Goes through the eyelid tissues.
в—‹ Causes an infection, such as an insect sting.
Fracture of the bone around your eye.
Infections that have spread from the eyelid or other structures around the eye.
Bite wounds.
Inflammation or infection of the lining

Osteomyelitis Case Study
Children's skeletal systems vary in terms of vascular patterns according to the age and developmental stages. Therefor, the clinical manifestations of
osteomyelitis usually differ from one child to another. Children between the ages of 1 year and puberty often experience a sudden onset of symptoms,
such as elevated body temperature and systemic signs of toxicity. They may complain swelling, redness, pain, and decreasing ability to bear weight on
the affected extremity. Long bones are the most commonly affected areas in children with osteomyelitis, but it may also affect the spine and pelvis
(McCance et al., 2010). The clinical manifestations of cellulitis are similar to osteomyelitis, such as swelling, warmth, tenderness, localized pain, and...
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According to Pagana and Pagana (2014), the normal range of CRP for children is less than 10.0 mg/L where as my patient's CRP level was 11.5
mg/L (p. 184). The infections in patient's right ankle and oral lesions most likely have triggered the liver to produce CRP during an acute
inflammatory process. However, a CRP test can only detect the presence of an inflammatory illness, but not the cause or the location of the illness.
Compared to ESR, the CRP test is more sensitive and responds more rapidly in an acute inflammatory change. Even though the levels of CRP increase
earlier and more intensely during an inflammatory process, they decrease rapidly and return to normal levels before the ESR normalizes when the
infection has been resolved (Pagana and Pagana,

Weight Gain And Obesity
polycystic ovarian syndrome also contribute to weight gain and obesity, and as well as medications. Obesity affects every body system, especially
cardiac disease is increased, as well as HTN, hypertriglyceridemia, and decreased HDL cholesterol. Remarkable weight gain increases the risk of
developing type 2 diabetes, obstructive sleep apnea, gastric reflux, urinary incontinence, and gallbladder disease (Grossman & Porth, 2014). Room
587 also struggles with HTN, sleep apnea, and gastric reflux. Her struggles with these comorbidities are caused by her morbid obesity, which led to
metabolic syndrome. Limited mobility and increased joint problems are also the results of too much weight on the body. Also in women, obesity
contribute to... Show more content on Helpwriting.net ...
Due to her obesity, she struggles with sleep apnea, which is a sleep–disordered breathing (SDB), accompanied by daytime symptoms. Sleep apnea can
be divided into two types, central sleep apnea and obstructive sleep apnea. Central sleep apnea is not common, and the cause is unknown. Central sleep
apnea is often associated with Cheyne–stokes breathing. Obstructive sleep apnea (OSA) is caused by upper airway obstruction and is mostly
associated with snoring, disrupted sleep, excessive daytime sleepiness, and is the most common type disease (Grossman & Porth, 2014). Room
587 has OSA, which is probably due to her obesity because sleep apnea is associated with obesity. Signs and symptoms of sleep apnea are loud
snoring and labored breathing interrupted by periods of silence that are soon followed by apnea. Treatment of OSA is based on the severity of the
condition. Behavior measures may be the only treatment necessary, such as weight loss, and proper bed positioning disease (Grossman & Porth,
2014). Since Room 587 is not willing to make an effort to lose weight, then one can say that she will struggle with this condition for a long time.
Another comorbidity that Room 587 has is a vascular disease, which is similar to PAD. Atherosclerosis is the main cause of PAD, which is mostly in
the vessels of the lower extremities. The popliteal arteries are affected the most, and when lesions develop, then the tibial, peroneal, and pedal vessels
can also be

Contraction and Spread of Streptococcus pyogenes
Contraction and Spread of Streptococcus pyogenes
Abstract:
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.
Introduction:
S. pyogenes is a ... Show more content on Helpwriting.net ...
It is also very transmissible through shaking hands, and handling something that a person with infected with pyogenes has touched. These are the most
common ways to contract Strep. throat. (2,3)
Also, contraction is very possible through the skin via abrasions both small and large. This type of infection would be contracted from exposure to
other people harboring the bacteria, bacteria in the air, or bacteria on the injured person. Being infected this way can rarely result in necrotizing
fasciitis. It is also very possible, albeit very rare, that Streptococcus pyogenes can be transmitted through food, most notably milk and its products.
This form of infection is usually caused by improper or lack of pasteurization of the milk. The bacteria that are responsible hardly ever come from an
outside source, and are usually present within the cow when infected milk is produced. However, these two other methods of transmission are far less
likely than the usual human–to–human respiratory infections. (6,2,1)
After the bacteria are first taken into the body, there is an incubation period of between one and five days. During incubation the bacteria are very
capable of infected others without the host having any knowledge of an infection. This is important in the spread of Strep. infections, which will often
occur through contact between children while at school. It is no mistake that the

Erysiples Case Study
What is the most likely diagnosis of the mouth lesions?
The most likely diagnosis is a cold sore, most commonly called the herpes simplex type 1 virus (HSV–1). Everyone has the virus in them and it will
present in times of stress, sun exposure, or a weakened immune system. The doctor will take a sample of the fluid from the vesicles if Don's history
warrants it.
Mode of transmission and is this a bacteria and a virus.
HSV–1 is a virus transmitted by direct physical contact like kissing, sharing food or utensils. It can also be transmitted by oral sex if your partner has
the virus.
What is the difference between erysipelas and cellulitis?
Erysipelas is a bacterial skin infection at the superficial level called the epidermis. Cellulitis ... Show more content on Helpwriting.net ...
1. Protection– An oily layer helps to keep out bacteria and viruses, the strength of the keratin provides a measure of defense from outside mechanical
sources (like if you hit your arm–if it is a light tap, you will only get a bruise). Your skin keeps out harmful radiation from the sun (ultraviolet rays),
and retains moisture so we don't dehydrate.
2. Regulation– Insulates the body to maintain temperature to achieve homeostasis. Sweat glands, vasoconstriction, and vasodilation are how this is
achieved. Your skin also provides cushioning for your internal organs. Imagine our skin is a blown up balloon...gentle pressure can be used to indent it
but as soon as you release pressure, it pops right back out.
3. Sensation– Tells us where it hurts. The pain receptors send signals to the brain saying "stop that– it hurts". Remember when you were a child and
you touched the hot burner on the stove? Your skin told you it was too hot and your autonomic reaction was to pull your hand away quickly.
4. Endocrine function– Aids in the absorption of Vitamin D3 through "the stratum basale and the stratum spinosum" (Wound Care Centers, 2014).
Without vitamin D, you can become lethargic. Sometimes it is called the "Winter Blues". You don't get enough sunshine during the winter. It's kind of
like hibernation– your body slows

Legend Of The Wild Mind Summary Chapter 14
Chapter thirteen features a twenty–three–year–old woman who came in with a red and swollen leg; typical cellulitis. She had a blister on her foot,
sweats, chills, a 103 degree fever, and the skin up to her calf was red. Her doctor had 'treated' it with intravenous fluids, a tetanus shot, and a
prescription for antibiotics. Then, the doctor had drawn a black line along the top of the redness and told her to come back if it spreads further. The
following morning, a rash and more pain had developed along with the redness now reaching a portion of her thigh. Dr. Gawande began the exam by
asking about any ulcers or pus, then checked the rash and leg. He came to the same conclusion as her doctor, cellulitis, but decided to check for
necrotizing fasciitis based on a gut feeling and a ... Show more content on Helpwriting.net ...
The father decided to do the biopsy and they took her back. Studdert removed an inch long ellipse of skin and tissue stretching from the top of the
foot to the tendon. Then, he removed some of the muscles at the center of the redness. Both samples were sent to the pathology department where a
dermatopathologist had later confirmed their suspicions. When she was taken into surgery, the destruction was obvious and they had questioned the
need for an AKA or BKA. However, they decided to trust their guts again and did a debridement and flushed out the muscles. Two hours later, she
was transported to another hospital and put in a hyperbaric oxygen chamber for two hours to boost muscle repair. The following day, she was taken
back into surgery to remove more of the infected muscle and they decided to increase the oxygen treatment to twice a day for two hours. Twelve days
later, she was released from the hospital bacteria free. A patch of skin, about sixty–four–square–inches, had been removed from her thigh and used as a
skin

Rehab Potential: A Case Study
Rehab Potential: good
Clinical Summary
Gordon Sroufe is a 90 years old male with PMH of DM, HTN, PVD, CKD, GERD, and hx of DVTs and PE who was hospitalized for left leg
cellulitis. He was treated with IV ATB and discharged on PO clindamycin. New medication teaching is completed. He verbalized understanding the
teaching. His left leg has an unopened blister (1.5x2.5cm) on his anterior aspect of his left leg. The blister has erythematic tissue around it. Betadine
was applied on the blister. And, wrapped with ACE wrap and rolled gauze. Pt's wife will do the wound care in the day pt is not going to get SNV.
Education regarding s/s of complication and importance of good blood glucose control to facilitate healing was completed. He verbalized understand
the teaching. ... Show more content on Helpwriting.net ...
No
If yes, summarize complications:
Has a specific body site been affected and/or has the disease process/surgery affected patient's dominant side? No
Pertinent past medical/surgical history: Diabetes mellitus Benign essential hypertension Hyperlipidemia PVD (peripheral vascular disease) GERD
(gastroesophageal reflux disease) Diabetic retinopathy Osteoarthritis Glaucoma Herniated disc lumbosacral DVT (deep venous thrombosis) greenfield
filter (2005) Adenocarcinoma of prostate s/p resection 1999 Pulmonary embolism greenfield filter (2005) GI bleeding intestinal ulcer on Coumadin
Leukocytopenia, unspecified Chronic renal failure, stage 4 (severe) Factor V Leiden mutation Right eye blind 20/40 vision on left eye and TKR x three.
Current and prior level of functioning: (ambulation/transfer ability (include reasons for other disciplines seeing patient)) Pt has a blister that needs
daily care. SN will monitor pt for any complication from Cellulitis.
If patient has refused other ordered services, why?

Pop A Pimple Research Paper
Popping a pimple
Do you ever want to pop a pimple to enhance the beauty of face? If so, then you must need to read this article and learn a lesson from women's story.
The internet is full with the videos and tutorials in which different people are popping pimples and others will attract with their videos and do the same
things. But sometimes things get worse then thinking of the people.
The same thing was happened with the 21–years–old Katie Wright from Austin as she shared her story on twitter as she tried to pop a pimple but it
results in pain and ugliness to her face.
Katie Wright from Austin:
Katie was the beautiful girl, attempted to pop a pimple as it hurts her but her reaction was:
'The pressure and heat from the face was unbearable ... Show more content on Helpwriting.net ...
But she thanks to the doctors that remains able to heal the infection and saved the life of the girl as she reached the hospital immediately and receive
early treatment for four days.
The doctor associated with this case added that 'If the infection of the pimple will run in the bloodstream of the person, it will cause several problems
including brain, eyes, joints, bones and sinuses and it was pretty hard to treat these organs of the body'
The fact is that term 'Cellulitis was not easy to recognize but it actually under diagnosed or over diagnosed but if people are feeling swelling and pain
in any area of the face they must need to visit the doctor to learn the actual cause of pain'
How to stay safe from any horrible incident after popping a pimple?
The doctor added the people should need to aware while popping a pimple as it always contains a risk and painful for the people. She added that:
'Whenever person wants to pop a pimple they must look deep before attempting the task and checks whether the pimple never associate with the
cellulitis and if the pimple was small soft white tip then it will be okay and you can pop

Streptococcus Pyogenes is More than Strep Throat Essay
Streptococcus Pyogenes: More than Strep Throat
S. pyogenes infections may vary from mild to life–threatening with a plethora of symptoms due to the many types of infections it causes. This
bacterium is responsible for the diseases of pharyngitis, rheumatic fever, impetigo, erysipelas, cellulitis, necrotizing fasciitis, acute poststreptococcal
glomerulonephritis, and toxic shock syndrome, just to name a few. Each of these infections has its own unique set of symptoms as will be explored in
depth below.
Streptococcus Pyogenes is a very diverse bacteria with effects ranging from nothing or a mild sore throat, to flesh eating disease, causing death in
40–60% of patients. The major and most common illnesses associated with this bacteria ... Show more content on Helpwriting.net ...
Initial diagnosis of Streptococcal pharyngitis is determined by a point system awarding 1 point for each of the following; temperature greater than 38
C, absence of cough, tender anterior cervical lymph nodes, tonsillar swelling, age younger than 15, subtracting a point for age older than 45. If these
symptoms are met, a rapid strep test will be performed before antibiotics are given, a precaution taken to prevent super–bugs from developing.
If a streptococcal infection such as pharyngitis or scarlet fever is left untreated, there is a small (~3%) chance that within approximately 20 days, the
patient will present with rheumatic fever. After the first bout of rheumatic fever, if the host acquires a second untreated S. Pyogenes infection, the
chance of coming down with rheumatic fever jumps substantially to ~50%. Most often this secondary disease will strike people aged 6–15 years old,
roughly 20 days after the streptococcal infection, with a 2–5% mortality rate. One of the major diagnostic symptoms of this disease is Erythema
Marginatum, snake– or ring–like eruptions covering the trunk, upper arms, and legs. Other symptoms include fever, arthritis (elbows, knees, wrists, and
ankles), swollen joints, pain in the abdomen, nodules

Orbital Cellulitis Essay
ORBITAL CELLULITIS
Description
Suppurative inflammation of adipose and soft tissues of orbit is termed as orbital cellulitis. It occurs more frequently in children than adults. Orbital
cellulitis and preseptal cellulitis are the major infections of the ocular adnexal and orbital tissues. Orbital cellulitis is an infection of the soft tissues of
the orbit posterior to the orbital septum, differentiating it from preseptal cellulitis, which is an infection of the soft tissue of the eyelids and periocular
region anterior to the orbital septum.
CAUSES
Orbital cellulitis can be caused by
1.Bacterial pathogens like Streptococcus and staphylococcus
2.Certain types of insect or spider bites also can transmit the bacteria that start the infection. ... Show more content on Helpwriting.net ...
5. For anaerobic infections Inj. Metronidazole 500 mg IV infusion 8 hourly, shifted to oral dose of 400 mg 8 hourly based on the clinical response for 2
weeks.
6. Oxymetazoline 0.05% nasal drops 2–3 drops in each nostril 2 times a day, in children: 0.025%.
7. Symptomatic therapy for pain: antipyretics and analgesics in usual doses.
8. Lubricating eyedrops/artificial tears: 1–2 hourly or antibiotic eye ointment 5 times a day to prevent exposure keratopathy.
Surgical treatment
Surgical drainage is indicated, if orbital abscess forms, based on clinical features, USG and CT scan findings; poor response or no response to the IV
antibiotic therapy, or if there is a threat to ocular function. It includes procedures like
1.Tarsorrhaphy or Frost suture to prevent exposure keratopathy.
2.Sinusotomy/craniotomy for pus in paranasal sinus or brain abscess respectively.
3.All the patients must be carefully monitored for vision, fundus, corneal exposure, ocular motility, pupillary reaction, corneal sensations, proptosis,
systemic status including CNS function.
Management
1.Warm compresses help in managing painful

Cellulitis is an acute inflammatory illness of the dermis and the subcutaneous tissue (Black, 2009, p. 1225). The pathophysiology of cellulitis initiates
when bacteria enters the skin, most commonly being streptococcus and/or staphylococcus. When the bacteria extends deeper into the dermis it causes
an infection. Causing skin symptoms such as redness, swelling, and tenderness around the site of the infection. Skin areas that may be dry and flaking,
broken, or wounded are the most prominent sites for bacteria to enter. Typically, cellulitis is treated with antibiotics. Possible complications of untreated
cellulitis include: septicemia, muscle or bone infections, cellulitis around an eye may spread to the brain, bloodstream may spread to the

Infection: A Case Study Of Mr. Y's Second Monologue
Mr. Y's second monologue reveals that he was given an antibiotic to prevent infection, but did not take the antibiotic as prescribed. He noticed his foot
was red and swollen, has not felt like eating and thinks he may have the flu. According to Mr. Y's symptoms, his second diagnosis includes cellulitis.
Cellulitis is an acute bacterial infection of the skin and can occur anywhere on the body, but most commonly affects the lower limbs. Any compromise
in the skin's integrity, including an open wound such as an ulcer, can allowbacteria to enter and result in cellulitis (JCN, 2014).
The first step in the treatment of cellulitis includes antibiotics. If Mr. Y had been compliant with taking the prescribed medication, he may have
prevented this

Agp Health History
Health History–7p It is important for AGNP to take thorough health history in diagnoses and management of cellulitis. AGNP should obtain
information about past medical and surgical history, current medications, allergies, nutrition, hydration, skin integrity, mobility, cognition, and
behavior. Risk factors for cellulitis include disruption of the cutaneous barrier and compromised venous or lymphatic system such as leg ulcer,
traumatic wound, dermatoses, venous insufficiency, obesity, and previous history of cellulitis (Buttaro et al., 2013). AGNP should ask questions about
location, onset, duration, degree of spread, and presence of pain. It is important to investigate whether there was a pre–existing wound or trauma to
involved area as well... Show more content on Helpwriting.net ...
Financial or health problems may result in loss of a home, social status or independence in adults. Patients should be asked about primary source of
income, living arrangements and with whom they live as well as family dynamic and whether he or she is the primary income producer for the
family. According to Barkley, the economic profile of many elderly is poor accounting one in every six elderly live below the poverty line in U. S.
(2014). If the patient has to pay out of pocket over the amount they can afford, it is more likely that he or she will not follow up with treatment
regiment or future appointments. Obtaining such information early will help practitioners to develop plan of care accordingly and provide additional
resource referrals that patients may

Deep Neck Space Infection Essay
Deep neck space infection (DNSI) means infection in the potential spaces and fascial planes of the neck, either with abscess formation or cellulitis.
Before the antibiotic era, infections of the deep fascial spaces of the head and neck were fairly common and were a source of considerable morbidity
and mortality. The advent of antibiotics has reduced the overall number of deep neck space infections but the same still occur in the general population,
with a definite potential for significant morbidity, and even mortality, with improper or delayed treatment. DNSI are found more commonly in
individuals of specific groups such as, immunocompromised individuals recovering from organ transplants or chemotherapy, or those with acquired
immunodeficiency... Show more content on Helpwriting.net ...
Treatment of DNSI includes antibiotic therapy, airway management and surgical intervention. Management of DNSI is traditionally based on prompt
surgical drainage of the abscess followed by antibiotics or nonsurgical treatment using appropriate antibiotics in the case of cellulitis. The advent of
modern imaging techniques has made it possible to diagnose these complications earlier and to localize them exactly. Proper diagnosis and prompt
management can effectively overcome the disease and provide a cure without complications. The main aim of our study was to share our experience in
terms of presentation, clinical trends, common sites involved, bacteriology, management, complications, and outcomes. The study also emphasizes the
importance

Cellulitis, Pediatric
Cellulitis is a skin infection. The infected area is usually red and tender. In children, it usually develops on the head and neck, but it can develop on
other parts of the body as well. The infection can travel to the muscles, blood, and underlying tissue and become serious. It is very important for your
child to get treatment for this condition.
CAUSES
Cellulitis is caused by bacteria. The bacteria enter through a break in the skin, such as a cut, burn, insect bite, open sore, or crack.
RISK FACTORS
This condition is more likely to develop in children who:
Are not fully vaccinated.
Have a compromised immune system.
Have open wounds on the skin such as cuts, burns, bites, and scrapes. Bacteria can enter the body through these open ... Show more content on
Helpwriting.net ...
Lab tests.
Imaging tests.
TREATMENT
Treatment for this condition may include:
Medicines, such as antibiotic medicines or antihistamines.
Supportive care, such as rest and application of cold or warm compresses to the skin.
Hospital care, if the condition is severe.
The infection usually gets better within 1–2 days of treatment.
HOME CARE INSTRUCTIONS
Give over–the–counter and prescription medicines only as told by your child's health care provider.

If your child was prescribed an antibiotic medicine, give it as told by your child's health care provider. Do not stop giving the antibiotic even if your
child starts to feel better.
Have your child drink enough fluid to keep his or her urine clear or pale yellow.
Make sure your child avoids touching or rubbing the infected area.
Keep all follow–up visits as told by your child's health care provider. It is very important to keep these appointments. They allow your health care
provider to make sure a more serious infection is not developing.
Have your child raise (elevate) the infected area above the level of the heart while he or she is sitting or lying

Right Leg Cellulitis Case Studies
Sensitizing Events: The patient did not receive a blood transfusion in the past. He did not have a previous transplant. Past Medical History: The patient
has a history of end–stage renal disease secondary to IgA nephropathy, hypertension, alcohol abuse, biopsy proven liver cirrhosis, history of right leg
cellulitis, Past Surgical History: AV fistula placement, catheter placement and removal placed in the right forearm, [__8:40__] surgeries. Social
History: Marital status: The patient is divorced. He is currently engaged and lives his with his fiancГ© for the last 14 years. Highest educational
level: He has attended trade school in the past. Occupational history: He used to work in construction but he quit in 2013 when he started dialysis.
He currently is on disability. Smoking: Patient has a history of heavy smoking in the past. He used to smoke two packs per day from age 13 to age 56.
He quit one... Show more content on Helpwriting.net ...
g)If[__18:21__] Doppler of lower extremity was not done at Tampa General Hospital this year, we will obtain it. 4.Obtain the following tests.
a)CT of chest and neck without IV contrast given the long history of smoking and the fullness in the neck of the left side. b)Obtain pulmonary
function tests if not done at Tampa General Hospital this year. c)Obtain regular serology work up and HLA [_18:57___]. d)Obtain dental clearance
if not obtain at Tampa General Hospital this year. e)Obtain drug screen. f)Obtain formal hepatology clearance at Tampa General Hospital after liver
biopsy was performed. g)Obtain CT of abdomen and pelvis with and without IV and P.O. contrast in four phases to look for masses in the liver and
measure portal blood pressure. 5.After all these records are obtained and the tests are done, and after the patient will go through six months of alcohol
abstinence documented by routine visits to AA, the patient will be discussed in MRB for

The Management Of Middle Aged Adult By An Adult Geriatric...
This paper outlines the management of cellulitis in middle aged adult by an adult geriatric nurse practitioner (AGNP). Cellulitis is an acute skin
infection that rapidly spreads and extends deeply from the dermis to subcutaneous tissue, characterized by erythema, warmth, and pain (Buttaro,
Trybulski, Bailey, & Sandberg–Cook, 2013). Although cellulitis is most common on lower extremities in adult, other parts of body such as
abdominal wall, head and face may be involved (Bailey & Kroshinsky, 2011). Erysipelas is a superficial form of cellulitis that involves the lymphatic
system that is characterized by a sharply demarcated and indurated border that is painful and bright red (Buttaro et al., 2013). Because of similar
clinical presentation... Show more content on Helpwriting.net ...
PSC is great theory to guide AGNP to manage the patient holistically and to give compassionate patient care. The main concept of Watson's PSC is
caring. Although this theory is based in nursing and nursing science, it has been incorporated into a variety of other disciplines, increasing its relevance
in many other fields and validated in many clinical settings (McEwen & Willis, 2007). Watson has background in psychiatric–mental health nursing and
received her doctorate degree in education psychology and counseling in Colorado, 1973. Related to nursing metaparadigm, Watson definedhuman
being as a valued person to be cared for, respected, nurtured, understood, and assisted; health as the unity and harmony within the mind, body, and soul
associated with the degree of congruence between the self as perceived and the self as experienced; and nursing as a human science of persons and
human health – illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions (George, 1990).
Instead of defining fourth concept of nursing metaparadigm, environment, Watson formulated that caring exists in all societies and is passed by the
profession as a unique way of coping with the environment (McEwen & Willis, 2007).
Watson believed that the main focus in nursing is on carative factors which are derived from a humanistic perspective combined with a scientific
knowledge base (George, 1990). Seven assumptions about the science

Stevens Johnson Syndrome Case Study
It is important to differentiate between erythema multiform and Stevens johnson syndrome: Erythema multiform: target lesion is the classic
presentation, and the 3 skin manifestations are dusky center, inner pale ring, and erythematous outer border. It usually affect age 10–40y/o.
Hypersensitivity reaction is most commonly triggered by infection so treat the underlying cause. HSV is most common cause so treat with acyclovir. It
is a self limiting condition. Stevens–Johnson Syndrome (SJS): is a life threatening reaction. Many manifestations are involved such as detachment of
the epidermis, acute blisters, erosion, severe purulent conjunctivitis, stomatitis and purpura macules. The main etiology is medications. Usually started
as a high fever and flu–like symptoms followed by mucocutaneous symptoms. SJS patients are managed like a burn patient.... Show more content on
Helpwriting.net ...
The main feature is honey crusted lesions. Can be bullous (30% of cases), or non bullous (70% of cases), and Ecthyme is ulcerative form of impetigo,
in which lesions extend through epidermis and deep into dermis. The lesions may appear 4–10 days after exposure to the infection. Sores are
contagious as long as there is fluid weeping from them. No longer contagious when they have scabbed over or 24–48 hours after starting antibiotic
treatment. Education is very important e.g. frequent hand washing. Cellulitis: Diffuse inflammation of the soft or connective tissue due to infection, in
which a thin, watery exudate spreads through the cleavage planes of interstitial and tissue spaces. The most common cause of cellulitis in children is
Staphylococcus aureus or Streptococcus pyogenes . The complications include abscess formation (e.g., peritonsillar abscess), Arthritis, osteomyelitis, or
lymphangitis. it is important to take location in to consideration because it can affect

Cellulitis Case Studies
The chief complaint is left knee, foot and calf soreness and ankle swelling without any injury for approximately seven days. He states that he has
pain in his left knee, soreness to his calf with swelling and redness to his left ankle but no temperature changes to his left leg or foot. He states that
his calf pain increases with dorsiflexion of his left foot; therefore he has a positive Homan's sign. He describes the pain in his knee as pressure and
rates the pain as 4/10. These symptoms lead to the concerns of deep venous thrombosis (DVT).
Differential diagnosis:
1.DVT
2.Cellulitis
3.Superficial thrombophlebitis
4.Muscle strain or tear
5.Osteoarthritis
The considerations in the differential include the listed symptoms. The possibility of a DVT is the most urgent and requires immediate evaluation due
to the potential consequences to the patient. The patient has a positive Homan's sign, reduced pulses, the swelling of the left lower leg. This diagnosis
is likely. The diagnosis of cellulitis is also a possibility due to the redness along with the swelling of the lower left extremity. However, the patient's
body temperature is normal, indicating the lack of infection ... Show more content on Helpwriting.net ...
A DVT is a venous blood clot that occurs as a result of the interaction of several factors. These include venous stasis, activation of blood coagulation
and damage to the endothelial lining of the vein (Patel, 2015). The result is increased viscosity of circulating blood and the formation of thrombus. The
blood test that is used to determine the presence of DVT is D–dimer. The level of D–dimer remains elevated for 7 days after the formation of a DVT.
Blood tests of prothrombin time and partial prothrombin time are also obtained to determine coagulopathy. The gold standard for the diagnosis for
DVT is a Doppler ultrasound of the affected extremity (Guerrero, McEwen, Masri, Nicolaou & Salcudean,

Summary Of Kelly's Story
1.)After reading Kelly's story I researched different skin infections that may cause a rash on a person. Four different infections I found were Scabies,
Impetigo, also known as Indian Fire, Cellulitis, and Folliculitis (7). Scabies is a contagious rash caused by the itch mite Sarcoptes scabiei (6). Scabies
is a rash that produces red itchy bumps (6). Impetigo is caused by Staphylococcus and Streptococcus bacteria (5). Impetigo is extremely contagious
and is spread by close contact (5). Cellulitis can be caused by Staphylococcus and Streptococcus (4). Cellulitis is not contagious but causes a red
heated rash in the area of infection (4). Lastly, Folliculitis was listed as a rash causing infection. Folliculitis is a skin infection that causes a rash
around the hair follicles that look like red pimples (3). Although it can be caused by certain bacteria, causing damage to the hair follicles can cause this
infection (8). The normal bacteria that causes Folliculitis is Staphylococcus aureus (3).
2.) ... Show more content on Helpwriting.net ...
The most common cause for Folliculitis is Staphylococcus aureus (3). The definition of Folliculitis is an inflammation of the hair follicle on the body
(8). This is the diagnoses I came up with because after shaving Kelly noticed the rash on her legs. Folliculitis is known to occur when there is damage
to the hair follicle. Shaving can cause hair follicle damage in return can cause Folliculitis

Summary Of Wound Management
Cellulitis is inflammation of the skin resulting from infections such as Staphylococcus or Streptococcus bacteria. It can result from trauma, infection of
an open wound, and occurs most commonly in the lower extremities. (Wilson & Hopper, 2015)
The article "Wound management complicated by cellulitis: a patient's experience," details a case study that involves a patient in the UK that after
receiving a big bite, was diagnosed with cellulitis. The case study highlights the impact of illness and poor skin regimens from the patient's perspective,
as well as the economic costs of wound care in the healthcare industry. (Metcalf & Torkingtonstokes, 2017)
The patient had no evident comorbidities. An IV antibiotic regimen was begun and after 5 days,

Erysipelas or St. Anthony's Fire and Aetiology are Painful...
Description
Erysipelas, also referred to as St. Anthony's fire, is a rapid bacterial skin infection involves the dermis and hypodermis of the skin that result with
severe pain and systemic symptoms (Kilbum, Featherstone, Higgins & Brindle, 2010). As O'Connor & Paauw (2010) described, it is presented mostly
with shiny and erythematous plaque, well–demarcated and indurated.
Erysipelas commonly occurred in the legs, 90% of the cases, then involves in the face which have a characteristic butterfly distribution on both cheeks
and nose follows by arms and thighs (Bonnetblanc & Bedane, 2003; Linder, Johansson, Thulin, Hertzen, Morgelin, Christensson, &...Akesson, 2010;
Davis, Cole & Benbenisty, 2012).
The typical symptoms are include,
пЃ¬fever, chills and shaking
пЃ¬malaise
пЃ¬red, firm, swollen skin
пЃ¬marked lesion with raised border or blisters
пЃ¬burning pain, pruritus, tenderness and sore
пЃ¬swollen glands
Aetiology
Streptococci, streptococcus pyogenes, is the predominant cause which group A affects mostly on facial infections and non–group A affects the lower
extremity (Gunderson & Martinello, 2012). These toxins are contributing the rapid inflammation which they normally live on body surface without
causing problem, then once they penatrated via tinea pedia or eczema that causes the skin breakage and developing erysipelas (Gabillot–Carre &
Roujeau, 2007).
The possible risk factors are,
пЃ¬cuts, erosions, blisters and ulcers in the skin
пЃ¬surgical incisions specially after

LRINEC Score
Blood sampling is also useful, and protein and cell levels can be used to calculate a LRINEC score. LRINEC stands for Laboratory Risk Indicator for
Necrotizing Fasciitis and is a great tool for distinguishing common skin infections from necrotizing fasciitis. In addition, its score is used to determine
if immediate surgical debridement is necessary. Measurements included in the LRINEC score is C–reaction protein, white blood cell count,
hemoglobin, sodium, creatinine, and glucose (16). CRP levels vary drastically among cellulitis and necrotizing fasciitis. CRP stands for C–reactive
protein, which is a naturally produced chemical in the liver that serves as a blood test marker for inflammation throughout the body. A high CRP level
indicates

Cellulitis: A Skin Infection
Cellulitis, Pediatric
Cellulitis is a skin infection. The infected area is usually red and tender. In children, it usually develops on the head and neck, but it can develop on
other parts of the body as well. The infection can travel to the muscles, blood, and underlying tissue and become serious. It is very important for your
child to get treatment for this condition.
CAUSES
Cellulitis is caused by bacteria. The bacteria enter through a break in the skin, such as a cut, burn, insect bite, open sore, or crack.
RISK FACTORS
This condition is more likely to develop in children who:
Are not fully vaccinated.
Have a weak defense (immune) system.
Have open wounds on the skin such as cuts, burns, bites, and scrapes. Bacteria ... Show more content on Helpwriting.net ...
Make sure your child avoids touching or rubbing the infected area.
Have your child raise (elevate) the infected area above the level of the heart while he or she is sitting or lying down.
Apply warm or cold compresses to the affected area as told by your child's health care provider.
Keep all follow–up visits as told by your child's health care provider. This is important. These visits let your child's health care provider make sure a
more serious infection is not developing.
SEEK MEDICAL CARE IF:
Your child has a fever.
Your child's symptoms do not improve within 1–2 days of starting treatment.
Your child's bone or joint underneath the infected area becomes painful after the skin has healed.
Your child's infection returns in the same area or another area.
You notice a swollen bump in your child's infected area.
Your child develops new symptoms.

SEEK IMMEDIATE MEDICAL CARE IF:
Your child's symptoms get worse.
Your child who is younger than 3 months has a temperature of 100В°F (38В°C) or higher.
Your child has a severe headache, neck pain, or neck stiffness.
Your child

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