Scribd
Upload
13 views30 pages

Pink Perplex

A 15-year-old male from Madurai presented with high-grade fever, body rashes, vomiting, and swelling on the left forehead. Provisional diagnoses include scarlet fever and furunculosis, with various investigations conducted revealing no significant abnormalities. Treatment involved antibiotics, hydration, and dermatological care, with the patient showing signs of diffuse desquamation at discharge.

Uploaded by

priya selvaraj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
13 views30 pages

Pink Perplex

A 15-year-old male from Madurai presented with high-grade fever, body rashes, vomiting, and swelling on the left forehead. Provisional diagnoses include scarlet fever and furunculosis, with various investigations conducted revealing no significant abnormalities. Treatment involved antibiotics, hydration, and dermatological care, with the patient showing signs of diffuse desquamation at discharge.

Uploaded by

priya selvaraj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 30

THE PINK

PERPLEX
🍓
CHIEF : PROFESSOR DR. SYED BAHAVUDEEN HUSSAIN MD
ASST PROFESSORS :
DR. VINOTH KANNAN MD
DR. PRIYA MD
PRESENTOR: DR. SHYAMALA 1ST YR PG
Presenting Complaints
• 15 yr old male patient native of Madurai came with
complaints of Fever for 3 days
• Fever : high grade, intermittent, not associated with
chills and rigor
• H/O rashes all over the body for past 2 days, except
face, first started in neck and upper trunk later
involved proximal extremities
• H/O vomiting 2 days - 4 to 5 episodes per day (only
food particles)
• H/O sore throat+ 3 days back
• H/O swelling over the left forehead for past 5 days
• Associated with pain, initially smaller in size
(peanut sized) later progressed to painful red
swelling of a larger size
• No h/o loose stools
• No h/o abd pain
• No h/o burning micturition
• No h/o joint pain
• No h/o cough with expectoration
• No h/o dysphagia at present
• No h/o reduced urine output
• No h/o any recent travel
• No h/o altered sensorium
Past History
• No similar complaints in the past
• No known comorbidities

Personal History

• No h/o substance abuse


• Normal sleep and appetite
• On mixed diet
• Normal bowel and Bladder habits
General Examination
• Toxic
• Febrile
• Dehydration +
• Mechanical ptosis left eyelid+
• No Pallor
• No Icterus
• No Cyanosis
• No conjunctival injection
.

• No Clubbing
• No Lymphadenopathy
• No Pedal edema

• No external markers of TB/ HIV

Vitals :
• BP - 100/60 mmhg
• Pulse - 104/min
• Spo2 - 99% RA
• Temperature - 103 F
Systemic Examination
• CVS : S1S2 Heard, No murmur

• RS : BAE+, No added sounds

• PA : Soft, BS+, No Organomegaly


• Oral Cavity : Strawberry tongue

• CNS : Conscious, Oriented, Ambulant, bilateral


pupil 3mm RTL
Dermatological
examination
Generalised rash (discrete papular rash moreon
upper trunk, neck, upper limbs)
Palms and soles normal
Scalp normal
Oral cavity: buccal mucosa normal, strawberry
tongue present
Nails normal
Local Examination
• Left forehead :

• Swelling of size 2x3 cm


• Redness+, warmth+, tenderness+
• Pus pointing+
• No Pus/ bloody discharge
PROVISIONAL
DIAGNOSIS
• FEVER WITH RASH DAY 3, ?SCARLET FEVER
• ? FURUNCULOSIS
Investigations 14.6.25
17.6.25
TLC 14000/mm3 12000/mm3

Hb 10.9 g% 11.7g%
.
Platelet 1.79 L 2.12 L

Urea/ Creat 75/1.8 mg% 35/0.9 mg%

Na/K 121/5.2 mg% 133/3.9 mg%

T. Bil 1.9 mg/dL 1.1 mg/dL

SGOT/SGPT 42/44 U/L 47/55 U/L

ALP 144 U/L 97 U/L

RBS 110 mg%


• Urine Albumin : nil
• Urine Sugar : nil
• Urine Deposits : 0-2 pus cells

• VCTC & VM : Negative

• ECG: Normal
Chest X ray
USG Abd and Pelvis
• Liver : 14.6 cms and normal echoes
• Gallbladder: no e/o calculus / wall thickening
• Spleen :10.3 cms, normal echoes
• Kidneys : Normal size and echoes, CMD +

IMPRESSION : Nil significant abnormality


Fever Chart
Dermatology Opinion
• Impression : ? Scarlet fever, Furuncle, Miliaria rubra

• To do: ASO Titre, Pus C/S, ESR, CRP, Blood C/S

• Advised :
Inj. Ceftriaxone 1g is od atd,
Adequate hydration,
Inj. Paracetamol 1g iv tds,
Zinc cream e/a,
Surgery Opinion

• Incision and drainage of the furuncle done


• Pus C/S of the drained pus
• Continue higher iv antibiotics
• Review in surgery OPD with reports
Dermatology Review
• Impression : ?Scarlet fever, ?Miliaria rubra

• Adviced :
Adequate hydration
Liquid Paraffin external application bd
Tab. Cetrizine 10 mg hs
Treatment given
• Inj. Piperacillin tazobactum 4.5 gm iv tds
• Cap. Doxycycline 100 mg bd
• Tab. Paracetamol 500 mg tds
• Zinc cream external application
• Tab. Ranitidine 150 mg bd
• Tab. Cetrizine 10 mg hs
• Inj. Ondansetron 8mg iv sos
At the time of discharge

.
.

• Diffuse desquamation skin lesions


• desquamation of lips
LET'S DISCUSS

You might also like