A not so busy morning spent mostly in OPD. I was able to check on my peds admission—the child with pus coming out of his ears, eyes and gums. Dr. C believes it to be Cancrum oris. He was better this morning. Taking food by mouth, general appearance better. His eyes and ears had been cleaned up, and the swelling looked to be less.
The young high schooler with painful unilateral orbital and cheek swelling and bilateral hand and wrist swelling came back with his lab results: slightly elevated WBC’s, everything else, including urine was normal. (though, we cant get a creatinine or electrolytes) I decided to treat him for orbital cellulitis and will have him follow up in a week. Meanwhile, I hope to think about this a little more. . . he was also complaining of photophobia at times and eye pain. I was wondering about uveitis. We don’t have a slit lamp.
Other interesting patients: a young boy with terminal hematuria, empirically treated for bilhariza (schistosomiasis), a young girl with corneal FB, a hydrocele the size of a small watermelon, a child with either a thyroglossal cyst or a strange lymph node (we aren’t exactly sure which). And, then the usual sick patients with ISD in its variable permutations: gastroenteritis, disseminated Herpes Zoster, rheumatic joint pain, headaches, generalized lymphadeopathy, candidiasis, and TB vs. PNA.
I admitted a 20 kilogram boy of 12 with ISD named Gerald because he has septic wounds all over his scalp from disseminated ringworm. He started to cry when I admitted him because he didn’t want to miss any school. He says his favorite subject is English.
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