Category: General Medicine

POTENTIAL DIAGNOSTIC CLUES TO CAUSES OF ACUTE LOCALISED INFECTIONS

Dr.Urusa InamdarLeave a comment

Written by : Dr. Urusa I Inamdar

  • ENT
  1. Tonsillar enlargement
  2. Exudate sinus tenderness
  3. Ear discharge
  4. Appearance of drum , mastoid tenderness
  • Cardiovascular
  1. New or changing murmur
  2. Peripheral signs of endocarditis
  • Hepatobiliary
  1. Tender hepatomegaly
  2. Murphy’s sign

https://youtu.be/2T0XUQ1M-x0

  • Genitourinary
  1. Suprapubic tenderness
  2. Renal angle tenderness
  3. Vaginal discharge
  4. Cervical motion tenderness
  • Skeletal
  1. Localised bone tenderness
  2. Mono arthritis
  • Dental
  1. Periapical swelling and tenderness
  • Respiratory
  1. Crackles
  2. Bronchial breath sounds
  3. Egophony
  4. Pleural effusion (unilateral)
  • Abdomen
  1. Tenderness in a specific quadrant
  2. Tender lump
  3. Guarding , rigidity
  • Skin and soft tissue
  1. Cellulitis
  2. Necrotising fascitis
  3. Discoloration
  4. Bullae , crepitance
Cellulitis of skin
Necrotising Infection
Bullous skin
  • Lymph nodes
  1. Lymphadenopathy in a single region.

Reference

  • Dental notes
  • Gsk – webevent console
  • YouTube.com
  • Google search

Treacher Collins Syndrome

Charu LataLeave a comment
  • Recto-vaginal fistula
  • Microtia
  • Cleft palate
Radiographic findings
Fun fact! “Wonder” movie is based on a child suffering from Treacher Collins Syndrome! PS. It’s a movie worth watching 🙂

Source : Anil Ghoms textbook of oral medicine , Shafer’s textbook of oral pathology

Image source : Google images

Pyrexia of Unknown Origin ( Part -2 )

Dr.Urusa InamdarLeave a comment

Written by : Dr. Urusa I Inamdar

Clinical signs:

  • Fever from an infection often presents with night sweats and weight loss.
  • In a rheumatological cause patient present with:
  1. Arthralgia
  2. Myalgias
  3. Fatigue
  • In cancer patients, the presentation is more likely:
  1. Pain
  2. Lack of appetite

Physical examination – Infectious disease:

Physical findings with specific significance in patients:

Non imaging test for PUO:

Diagnostic imaging in patients with PUO:

Treatment:

In the majority of cases, treatment other than supportive care should not be commenced until a diagnosis is obtained. Early use of antipyretics or antimicrobial may delay diagnosis. The mortality rate for PUO is less than 10%.

If infective endocarditis is suspected, then the patient should be admitted to a hospital and empiric intravenous antibiotics should be commenced after three sets of blood cultures have been collected.

The recommended empiric regimen of infective endocarditis in Australia is gentamycin , benzylpenicillin and flucloxacillin; however this may vary with different patient factors and should be discussed with an infectious disease specialist.

References:

  • Davidson’s- Principles and practice of medicine
  • Gsk – webevent console
  • onlinelibrary.wiley.com
  • Dental notes