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Otolaryngology

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A 45 years old patient presented with swelling Lt middle finger. Further history taking reveals multiple pink papule with fine scales along trunk and extremities. Suspected Psoriatic arthropathy with guttate psoriasis?

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She was started on cephalexin and topical mupirocin 3 days ago. The wound is less red, less painful. She is able to do her daily exercise without problems. No other medical problems. Would you stop the antibiotics at this stage or continue for full 10 days? Exam reveals healthy granulation tissue with minimal tenderness. Erythema is almost completely resolved.
She was started on cephalexin and topical mupirocin 3 days ago. The wound is less red, less painful. She is able to do her daily exercise without problems. No other medical problems. Would you stop the antibiotics at this stage or continue for full 10 days? Exam reveals healthy granulation tissue with minimal tenderness. Erythema is almost completely resolved.
Patient with 1 year of reconstruction evolution with complete healing process.
Patient with 1 year of reconstruction evolution with complete healing process.
A 22-year-old male with no prior significant medical or psychiatric history presented to his primary care physician with a chief complaint of breathlessness, described subjectively as “unable to fully expand my lungs.” The symptom occurred in the absence of hyperventilation, cough, or chest pain. On examination, the patient was tachycardic, with a heart rate of 110 bpm, and blood pressure of 140/90 mmHg. His temperature was normal. Auscultation of heart and lungs was unremarkable. A chest X-ray was performed and showed no abnormalities. The patient was empirically started on oral corticosteroids for presumed subclinical airway inflammation, but reported no improvement after one week. A chest CT scan was subsequently obtained, which was also completely normal. Given the context of recent psychosocial stressors—relocation to a new city and university pressures—the symptom was attributed to anxiety, and the patient was referred to a psychiatrist. One month later, the patient returned reporting a new symptom: an urgent need to defecate only when outside his home, although he reports that there's nothing in his stomach to defecate. Abdominal ultrasonography revealed excessive colonic gas, but no structural pathology. Stool analysis was normal. A diagnosis of irritable bowel syndrome (IBS) was made. The following month, the patient developed overactive bladder symptoms, characterized by urinary urgency without infection. The month after that, he presented with psychogenic dysphagia, reporting inability to swallow even liquids, which led to significant anxiety but resolved partially with SSRIs. Another month later, he described a disturbing cardiac symptom—a sudden sensation in the chest resembling a missed heartbeat, a thump, or fluttering like a bird, especially at rest. ECG and 24-hour Holter monitoring were done and showed only sinus tachycardia, without arrhythmias. The patient was started on Escitalopram 20 mg and Amisulpride 50 mg by his psychiatrist, which led to partial improvement in mood and gastrointestinal symptoms. However, the air hunger and missed heartbeat sensations persist. His blood pressure remains consistently elevated at 140/90 mmHg, despite his young age and lack of risk factors. All laboratory tests (CBC, metabolic panel, thyroid function, inflammatory markers) were within normal limits. I honestly don't know what's the link to this case, the patient is mentally stable, I am suspecting lyme disease or babesia. let me know
A 22-year-old male with no prior significant medical or psychiatric history presented to his primary care physician with a chief complaint of breathlessness, described subjectively as “unable to fully expand my lungs.” The symptom occurred in the absence of hyperventilation, cough, or chest pain. On examination, the patient was tachycardic, with a heart rate of 110 bpm, and blood pressure of 140/90 mmHg. His temperature was normal. Auscultation of heart and...
It's redish wich affected only the chest and above the umbilicus. It disappears just to appear again.
It's redish wich affected only the chest and above the umbilicus. It disappears just to appear again.