Case Review 3

13 year Male child came with complains of swelling of the body starting from the periorbital area for 8 days and then pitting oedema on the legs for 2 days.There is no history of fever but he complains of headache, temporal aggravated by heat and there is Blurring of vision as well.

He complains of occassional productive cough with blood stained sputum.

No H/O sore throat, TB or other disease in tha past.

He is staying at hostel and his senior has tuberculosis.

O/E:

GC: fair

Vitals: BP=140/100, rest stable

JALCyClOD= Pitting Edema, Bilateral legs

Systemic Examination:
Chest/CVS/PA= No Abnormality detected

local: legs=pustular, echtymic rashes.

Xray: fluffy infiltrates bilateral

Urine:frothy,albumin ++,RBC-,pus cell-normal

Local: Rash in leg: Picture

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Case Review 1

USMLE case: surgery or medicine

 

A 13-year-old boy has a 3-day history of low-grade fever, upper respiratory symptoms, and a sore throat. A few hours before his presentation to the emergency room, he has an abrupt onset of high fever, difficulty swallowing, and poor handling of his secretions. He indicates that he has a marked worsening in the severity of his sore throat. His pharynx has a fluctuant bulge in the posterior wall. Which of the following is the most appropriate initial therapy for this patient?

A.Narcotic analgesics

B.Trial of oral penicillin V

C.Surgical consultation for incision and drainage under general anesthesia

D.Rapid streptococcal screen

E.Monospot test

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