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Case Study about Multisystem - Assignment Example

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A 24-year-old male presented to the clinic. He was placed on Bactrim DS for a skin infection. The patient began having a fever, sore throat, chills, headache and malaise, and arthralgias, with the development of non pruritic, mucocutaneous oral ulcerations. …
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Download file to see previous pages Physical examination must be made in a systematic fashion from head to toe with attention to the skin. Special attention must be paid to any abnormal vital signs or evidence of toxicity (Cash, & Glass, 2011). An important aspect of the physical examination will require the patient to get naked so that a proper evaluation can be made. This is needed as patients are often unaware of a rash on their back, buttocks, soles, or perineum. During the physical examination, involvement of the mucous membranes must be examined in areas including mouth, lips, conjunctiva, anus, and vagina. General diagnostic testing must be made so as to support the diagnosis. Biopsy is done by extracting a tissue sample from the patient’s skin for examination under the microscope. The biopsy results upon diagnosis will demonstrate detachment of the epidermis from the dermis. Recommendations for Management The initial step to be done in managing this disease is to identify the probable cause of the condition. If the disease is caused by medicine; then the subsequent action is to discontinue any medications suspected of causing Stevens Johnson Syndrome. According to Patterson, Grammer, & Greenberger early discontinuation of the etiologic drug has been reported to improve survival in patients (Patterson, Grammer, & Greenberger, Pg. 234, 2009). All medication started within the past months should be discontinued. Patients affected by this situation require immediate hospitalization; in burn centers or intensive care units. Such patients are treated in a manner similar to that of burn patients. Treatment for Stevens Johnson Syndrome is symptomatic and supportive. Supportive...
The initial step to be done in managing this disease is to identify the probable cause of the condition. If the disease is caused by medicine; then the subsequent action is to discontinue any medications suspected of causing Stevens Johnson Syndrome. According to Patterson, Grammer, & Greenberger early discontinuation of the etiologic drug has been reported to improve survival in patients. All medication started within the past months should be discontinued. Patients affected by this situation require immediate hospitalization; in burn centers or intensive care units. Such patients are treated in a manner similar to that of burn patients. Treatment for Stevens Johnson Syndrome is symptomatic and supportive. Supportive care given to the patient while he is hospitalized includes; fluid replacement, nutrition, wound care, and eye care. Special consideration must be given to airway as well as hemodynamic stability. Fluid status must also be considered in cases whereby the patient lost fluid via affected seeping areas where the skin came off. Its management focuses on the removal of the offending agent and replacement of fluid losses. This is done by intravenous fluid repletion. Great volumes of colloids and crystalloids are important in maintenance of electrolyte balance. Care of the wound must be made. ...Download file to see next pagesRead More
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