Pt. presents in the office today with a fever, diaphoresis (1) (excessive sweating) and right sided chest pain onset two days ago. Noticed erythema (2) (redness of the skin) two weeks ago to right breast. Now presents with petechia (3) (a small reddish-purple mark caused by a small hemorrhage) observed on epidermis (4) (the outermost layer of the skin) of right breast with a small 2cm macule (5) (a discolored patch of skin, it is discolored not elevated in nature) near the areola.
Ecchymosis (6) (known as a bruise) and papular (7) (a small solid elevation of skin, it forms in clusters, like a rash) is observed on right arm. Shows no sign of pruritus (8) (an itch, it is an unpleasant sensation that causes one to scratch). Pt. has a past history of healed decubitus ulcer (9) (are lesions that are caused by unrelieved pressure or friction) to right heel, sacral dermal abscess (10) (a localized collection of pus in any body part) that resulted in an ulcer (11) (a lesion of the mucous membrane or the skin).
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Pt. treated with incision (12) (a cut that is made into body tissue or organ) and debridement surgery. Genital warts treated with keratolytics (13) (a therapy used for wart removal) and cryosurgery (14) (the application of the extreme cold, it’s used to destroy abnormal/diseased tissue). Post 48 hour TB skin test given, resulting in a positive wheal (15) (a raised firm patch of skin, that either itch or have a burning sensation disappears usually in 24/48 hours).
Keratosis (16) (a growth of the horny layer of skin) on the face was treated using dermabrasion (17) (a procedure that involves wearing away the upper layers of skin with sandpaper) of epidermis on face. Pediculosis (18) (an infestation of lice) treated with parasiticides (19) (used to destroy parasites). Presently being treated for a yeast infection; with Antifungal (20) (is a medicine that is used to treat fungal infections) cream.
Will treat fever with antipyretics, and epidermis papular with antihistamines (21) (it suppresses the histamine induced wheal and flare response by blocking the binding of histamine to its receptors) . Obtain bloodcoultures, wound cultures from the mascule on breast, and will biopsy (22) (is a tissue sample removed from the body for microscopic examination) if necessary, Follow up with antibiotics if result of blood and wound cultures positive.