Complicated septal abcess | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Complicated septal abscess

54 yrs old female has operated for bilateral nasal septal abscess followed by second operation 1 week later due to impending osteomyelitis in the bony septum. She is diabetic type 2.

She is receiving imipenem vial 500mg *2 and her blood sugar is controlled.

She is checking her RFT and ESR nearly daily to show the response to medications, last tests of ESR were decreasing reaching to 53 but today was 90!

While the patients health is good apart from malaise.

Can I get help?

Thanks

Similar cases

24 female patient with hx of keratoconus and cross linking were performed bilaterally 2 years ago.

2 months ago she discovered that she has RD in the left eye so vitrectomy with silicon oil injection was done instead of buckle as she has thrombocytopenia. 1 month later she is developing cataract in her left eye. Can she be treated with corticosteroids for her ITP? Also, she is considering doing laser in her right eye as she has retinal weakness isn't this gonna be a problem with her plt 70,000? Any suggestions?

A 45 years lady comes to you with the complain of weakness. She has history of hematemesis of 14 years. It was occur 2-3 years interval. Before hematemesis she feels a mass in lower abdomen. When she came with this history you give her CBC with ESR, Prothrombin time with INR, endoscopy, liver function test, serum electrolytes USG of whole abdomen. All investigation report are normal. So what is your diagnosis?

Female, 52 years old, complains from anal pain that lasts all day, but disappears during sleep, and aggravates during the day. The condition started since 5 months after hemorrhoidectomy since 1 year. Patient describes pain as a burning pain and not related with defecation. Patient is diabetic and on oral glemipride 2mg and her blood glucose is within controlled range. She is hypertensive and on oral captopril and her blood pressure is within normal range. She had subtotal hysterectomy since 6 years with no post operative complications. She was given local ointment to relieve the pain, plus a trial of pregabalin and gabapentin plus citalopram for over two months with no improvement. She also took amisulpride 50 mg for 2 months and corticosteroids for 1 week plus neurovit amps with no improvement.

2 m. girl with congenital pathology, including huge coloboma of upper eyelid. she can't close her eye completely. I am planning surgery for her when she will 2. But if we will have problems with cornea, then will operate early.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?