Go Back   Professional Soldiers ® > TMC 14 > General Medical

Reply
 
Thread Tools Display Modes
Old 08-23-2017, 10:37   #1
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
Unknown condition resulting in blistering

Good afternoon all,

I have a friend who has been laid up in the hospital for a few days now, and they have no idea what has caused this blistering(all on same arm), her symptoms, or how to treat it(from what she's told me). They've ruled out bug bites.

I'm just trying to help a friend with any leads that she could pass onto her physicians. I've attached photos, and her current condition is:
  • 104 degree fever that hasn't broken
  • Redness all over the body
  • Dehydrated
  • Chronic headaches/migraines

I really appreciate any help with this. Thank you for reading.
Attached Images
File Type: jpg Blisters_1.jpg (38.5 KB, 65 views)
File Type: jpg Blisters_2.jpg (41.4 KB, 57 views)
File Type: jpg Blisters_3.jpg (37.2 KB, 56 views)
File Type: jpg Blisters_4.jpg (38.9 KB, 58 views)
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Old 08-23-2017, 10:53   #2
PedOncoDoc
Area Commander
 
PedOncoDoc's Avatar
 
Join Date: Oct 2009
Location: Northeast Utah
Posts: 1,712
Any new exposures/medicines/supplements/etc?
__________________
‎"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
PedOncoDoc is offline   Reply With Quote
Old 08-23-2017, 11:06   #3
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
I will ask, but to be clear, do you mean while she has been admitted, or prior to? Thank you for the reply
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Old 08-23-2017, 11:13   #4
PedOncoDoc
Area Commander
 
PedOncoDoc's Avatar
 
Join Date: Oct 2009
Location: Northeast Utah
Posts: 1,712
Quote:
Originally Posted by BryanK View Post
I will ask, but to be clear, do you mean while she has been admitted, or prior to? Thank you for the reply
Prior to the admission.
__________________
‎"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
PedOncoDoc is offline   Reply With Quote
Old 08-23-2017, 13:36   #5
Trapper John
Quiet Professional
 
Trapper John's Avatar
 
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,834
Doesn't look like a systemic allergic reaction to me. Looks more like a local reaction to a bite, sting, or contact to an allergen that has become infected and may be going systemic. Suspect Streptococcus. I would imagine the primary care facility will get a culture/sensitivity, thoroughly wash, debride the infection, bandage, and start her on some broad spectrum antibiotic (fluroquinolone like ciprofloxacin) until lab results indicate otherwise.
__________________
Honor Above All Else
Trapper John is offline   Reply With Quote
Old 08-23-2017, 13:39   #6
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
Quote:
Originally Posted by PedOncoDoc View Post
Prior to the admission.
She's been resting, so no definitive answer on that just yet. Her fiance let me know that her swelling has worsened, fever slightly lower, and has been in multiple antibiotics thusfar. I doubt I'll be privy to the dosages and types of antibiotics however.
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Old 08-23-2017, 13:43   #7
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
Quote:
Originally Posted by Trapper John View Post
Doesn't look like a systemic allergic reaction to me. Looks more like a local reaction to a bite, sting, or contact to an allergen that has become infected and may be going systemic. Suspect Streptococcus. I would imagine the primary care facility will get a culture/sensitivity, thoroughly wash, debride the infection, bandage, and start her on some broad spectrum antibiotic (fluroquinolone like ciprofloxacin) until lab results indicate otherwise.
She initially suspected a bite, but they have ruled that out somehow. She's on a variety of antibiotics, but the swelling has worsened. They have not given her or her fiancé any answers as of yet.

This is day 3 of her hospital stay.
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Old 08-23-2017, 13:56   #8
Trapper John
Quiet Professional
 
Trapper John's Avatar
 
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,834
Quote:
Originally Posted by BryanK View Post
She initially suspected a bite, but they have ruled that out somehow. She's on a variety of antibiotics, but the swelling has worsened. They have not given her or her fiancé any answers as of yet.

This is day 3 of her hospital stay.
Three days!! Variety of antibiotics!! Still has a low-grade fever!! Now ya got my attention.

What hospital is this? Did they get a culture & sensitivity to determine bacteria type and sensitivity to antibiotics? I am concerned about an antibiotic resistant strain. I am thinking that someone else may need to be brought in on this one. A local bacterial infection that is refractory to treatment for 3 days bothers me a lot.
__________________
Honor Above All Else
Trapper John is offline   Reply With Quote
Old 08-23-2017, 13:59   #9
PedOncoDoc
Area Commander
 
PedOncoDoc's Avatar
 
Join Date: Oct 2009
Location: Northeast Utah
Posts: 1,712
Staph and Strep skin infections are certainly is on the differential, as is Stevens Johnson Syndrome, hence my question about new medications and other exposures.
__________________
‎"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
PedOncoDoc is offline   Reply With Quote
Old 08-23-2017, 14:03   #10
Trapper John
Quiet Professional
 
Trapper John's Avatar
 
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,834
Quote:
Originally Posted by PedOncoDoc View Post
Staph and Strep skin infections are certainly is on the differential, as is Stevens Johnson Syndrome, hence my question about new medications and other exposures.
Now I got to go look that one up! Thanks a lot Doc.

Oh and on another subject I will be contacting you in a few week regarding GVHD.

Be well.
__________________
Honor Above All Else
Trapper John is offline   Reply With Quote
Old 08-23-2017, 14:04   #11
Old Dog New Trick
Quiet Professional
 
Old Dog New Trick's Avatar
 
Join Date: Mar 2011
Location: Just above the flood plain in Southern Texas
Posts: 3,609
MRSA

The initial presentation of MRSA is small red bumps that resemble pimples, spider bites, or boils; they may be accompanied by fever and, occasionally, rashes. Within a few days, the bumps become larger and more painful; they eventually open into deep, pus-filled boils About 75 percent of CA-MRSA infections are localized to skin and soft tissue and usually can be treated effectively.
__________________
You only live once; live well. Have no regrets when the end happens!

“The only thing necessary for the triumph of evil is for good men to do nothing.” (Sir Edmund Burke)
Old Dog New Trick is offline   Reply With Quote
Old 08-23-2017, 14:08   #12
Trapper John
Quiet Professional
 
Trapper John's Avatar
 
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,834
Quote:
Originally Posted by Old Dog New Trick View Post
MRSA

The initial presentation of MRSA is small red bumps that resemble pimples, spider bites, or boils; they may be accompanied by fever and, occasionally, rashes. Within a few days, the bumps become larger and more painful; they eventually open into deep, pus-filled boils About 75 percent of CA-MRSA infections are localized to skin and soft tissue and usually can be treated effectively.
And that is EXACTLY what is #1 on my DDx!
__________________
Honor Above All Else
Trapper John is offline   Reply With Quote
Old 08-23-2017, 14:25   #13
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
Quote:
Originally Posted by Trapper John View Post
Three days!! Variety of antibiotics!! Still has a low-grade fever!! Now ya got my attention.

What hospital is this? Did they get a culture & sensitivity to determine bacteria type and sensitivity to antibiotics? I am concerned about an antibiotic resistant strain. I am thinking that someone else may need to be brought in on this one. A local bacterial infection that is refractory to treatment for 3 days bothers me a lot.
I'm unsure of the tests she's had thus far, and I think she's probably unsure also unfortunately.

She's at Howard County General Hospital (Maryland), which is a branch of Johns Hopkins. If anyone could figure this thing out I'd think it'd be them, but they have me wondering now.

Quote:
Originally Posted by Old Dog New Trick View Post
MRSA

The initial presentation of MRSA is small red bumps that resemble pimples, spider bites, or boils; they may be accompanied by fever and, occasionally, rashes. Within a few days, the bumps become larger and more painful; they eventually open into deep, pus-filled boils About 75 percent of CA-MRSA infections are localized to skin and soft tissue and usually can be treated effectively.
I appreciate the insight, it certainly appears to be the case.
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Old 08-23-2017, 14:32   #14
Trapper John
Quiet Professional
 
Trapper John's Avatar
 
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,834
BryanK- She is fortunate that she has you for a patient advocate. Being affiliated with JH then you should be pushing for their infectious disease specialists to weigh in on this ASAP. Don't f' around with this and be an a'hole if you need to. Old Dog is right on this one, I'll bet money on it!

Good luck and be persistent.
__________________
Honor Above All Else
Trapper John is offline   Reply With Quote
Old 08-23-2017, 15:15   #15
BryanK
Guerrilla Chief
 
BryanK's Avatar
 
Join Date: Feb 2008
Location: VA
Posts: 859
Quote:
Originally Posted by Trapper John View Post
BryanK- She is fortunate that she has you for a patient advocate. Being affiliated with JH then you should be pushing for their infectious disease specialists to weigh in on this ASAP. Don't f' around with this and be an a'hole if you need to. Old Dog is right on this one, I'll bet money on it!

Good luck and be persistent.
Thank you sir. She has in fact seen the IDS, and still no word on a diagnosis. I understand it takes time, I just didn't figure it took that long to nail down.
__________________
"1000 days of evasion are better than one day in captivity"

"Too many men work on parts of things. Doing a job to completion, satisfies me."- Richard Proenneke
BryanK is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump



All times are GMT -6. The time now is 00:56.



Copyright 2004-2022 by Professional Soldiers ®
Site Designed, Maintained, & Hosted by Hilliker Technologies