For this assignment we will use the case of an individual who came to the walk-in clinic with complains of inflammation and pain on his left lower leg

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For this assignment we will use the case of an individual who came to the walk-in clinic with complains of inflammation and pain on his left lower leg

Responses to classmates must consist of at least 350 words (not including the greeting and the references), do NOT repeat the same thing your classmate is saying, try to add something of value like a resource, educational information to give to patients, possible bad outcomes associated with the medicines discussed in the case, try to include a sample case you’ve seen at work and discuss how you feel about how that case was handled. Try to use supportive information such as current Tx guidelines, current research related to the treatment, anything that will enhance learning in the online classroom. For this week’s post I will like to talk about Cellulitis, since this in an acute complaint that has be recurrent in my life, thus I decided to do a little bit of research in the causes and treatments available for this condition so I can be more knowledgeable on its management. The skin is the largest organ in the human body and it takes care of the body temperature regulation, storage of fat and water, barrier against the entry of bacteria, among other functions (Cranendonk, et al. 2017). Cellulitis is an infection of all the skin layers, normally caused by staphylococci, presenting with poorly demarcated erythema, edema, warmth, and tenderness (Cranendonk, et al. 2017). For this assignment we will use the case of an individual who came to the walk-in clinic with complains of inflammation and pain on his left lower leg. The patient is a 23 years-old Hispanic male who came to the clinic complaining of left lower leg that has persist for the past five days. Patient states that he was playing soccer and received a cut on his leg as result of the contact with the spikes of one of rival team’s defenders. Patient states he “felt the impact in his left lower leg, but did not pay too much attention since he has had worst while playing soccer”. At the end of the game, patient noticed a “little cut, approximately one inch” below his left knee, but once more, he did not paid attention to that since it is common in this kind of games to get a “little scratch”. Patient states that for the next days he was seeing his leg getting swollen, and the pain increasing so he decided to come to the clinic because he suspects “he had an infection on the leg”. The patient identifies the onset of the symptoms five days ago, “two days after the soccer match”; when he was able to notice a redness and swollenness just below his left knee. These symptoms have persisted for the last five days. Patient complained of tenderness in the affected area that remains all time and is painful to touch in the area. Pain is relieved by resting and elevation of the extremity, while is aggravated by activity and touch. Patient denies any fever, nausea, nor numbness on the affected area. Patient has been using Tylenol for pain and has been washing the wound with warm water and soap. Patient is healthy in general terms, no chronic condition has been diagnosed, he has an athletic complexion with an appropriated BMI, with no history of previous complains. Patient has never had surgery. On his family we can find relevant history of Cardiac conditions, mostly CHF, and Cancer; no history of diabetes, COPD, or other condition is recalled by the patient. Patient can’t be differentiated in treatment based on his actual complaint; patient has no known allergies, and his family have no know allergies either, according to his statement. The social history of the patient does not impact directly the chief complaint since the events that lead to the actual condition do not have relevance based on social history. The patient is a informatics engineer who spent mostly of his time programing informatics systems for a large company in the US. On general assessment the patient showed a deep, pitting edema on his left lower leg +2, which is warm and tender to touch. Pain is alleviated by elevation and rest, while worsen with movement and touch. Patient denies nausea, vomiting, patient denies any other symptom other than the tenderness and swollen of the affected extremity (Linder & Malani, 2017). The practitioner used the BATHE Technique to explore the whole situation of the patient and no further data was obtained after the initial patient’s statement. On assessment patient’s skin presents a 3.45 cm cut on his left leg, 4 inches below the knee, which is draining a yellowish fluid with traces of blood; patient also presents a +2 edema that goes from below the left knee to mid left lower leg. Blood pressure 135/58; pulse 75; respirations: 17; O2 Sat 98 RA; and temp: 99 F axillary. Patient denies any pain at this time. Lung sounds present and WNL in all lobes; bowel sounds active in all quadrants; no further complaints are reported by patients. Skin is dry and intact, other that the mentioned open area. After history and assessment, the practitioner diagnosed the patient with Cellulitis since this condition is characterized by a bacterial infection of the skin and the soft tissues underneath. It happens when bacteria enter a break in the skin and spread. The result is infection, which may cause swelling, redness, pain, or warmth. The practitioner will order a CBC to confirm the presence of infection, as well as OTC Ibuprofen to control pain and swelling; and rest to prevent further swelling on the affected area (Raff & Kroshinsky, 2016). Since not foreign object presence is suspected, no X-Ray or other imaging test will be recommended. If lab tests show the presence of an infection, the practitioner could recommend a culture to define if the bacteria is resistant to brad spectrum antibiotics (Linder & Malani, 2017); but commonly they will order a broad spectrum one for up to 14 days and, if not resolved, ordered a culture and try with more powerful antibiotics, depending on the pathogen. In this particular scenario Regards Cesar Almanza References Cranendonk, D. R., Lavrijsen, A. P. M., Prins, J. M. & Wiersinga, W. J. (2017). Cellulitis: current insights into pathophysiology and clinical management. The Netherlands Journal of Medicine, 75 (9), retrieved from http://www.njmonline.nl/article_ft.php?a=1907&d=1260&i=210 Linder, K. A. & Malani, P. N. (2017). Cellulitis. JAMA, 317 (20), doi: 10.1001/jama.2017.5205. Raff, A. B. & Kroshinsky, D. (2016). Cellulitis: A review. JAMA 316 (3), doi: 10.1001/jama.2016.8825