72M With Recent Fever Gluteal Abscess Heart failure Telangan PaJR

 

20-02-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

PPM 1 - 

Afternoon ward:

Also introducing @PPM3 who was lured into this group following a discussion in another group on how to create a connected blended learning ecosystem toward real time audit to prevent errors before they happen.

The other theme of this group is off course bridging bench to bedside gaps.

Starting from the bedside of this 72M with recent fever treated with im injections in the community that not only caused a gluteal abscess but also perhaps drug induced AKI and heart failure leading to shortness of breath (in keeping with the theme of medical errors!) other than the fact that he also has COPD (used to smoke 20 bidis per day) that may have gotten exacerbated due to the recent viral fever.

Bedside paper based EMRs

Bench Radiology 72M

Bench Electrophysiology

Bench Labs

21-02-2025

Afternoon Bedside update of yesterday's 72M patient shared above

Subjectively feels much better in terms of less cough, burning over chest and currently has no fever.

Bedside update 72M: 

His initial problem was fever and cough a month back following which he received a gluteal injection and developed a pain and swelling in that area. The right hand and finger is the patient's own pointing out the exact site and it missed the sciatic nerve by a whisker!

Bench: Although his sciatic nerve was lucky unlike our previous patient which @PPM4 published here:

 https://pmc.ncbi.nlm.nih.gov/articles/PMC4785487/

 he still managed to develop a gluteal abscess with pain intensifying the day after the gluteal injection.

His current bench derived leucocytosis is likely due to the abscess and his renal damage leading to AKI is likely due to all the antibiotics he received for it as well as his preceding viral fever (most of which was unnecessary)!