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Posted

Diabeetus?

BGL is 103mg/dl No past medical history.

Any travel history, sick contacts, history of the same?

Except for area soccer games none. He has a upper respiratory tract infection that is being treated with the medications from the previous posts bbut other than that thats all the medical history he has. He plays soccer and is in great physical condition.

Posted (edited)

What part of the country are we in? Any known tick, mosquito or other insect bites?

Edited by ERDoc
Posted

whats the family history?

Posted

You said it was a professionally cleaned house... recently cleaned? Exposure to cleaning agents? Just a thought.

I'm curious... could this be an atypical presentation of Stevens-Johnson Syndrome? The flushed red skin fits, and if he's got the rare zebra of a lesion on the myocardium, that could account for the chest pain... SJS is associated with antibiotic use, including 'cillins... may be he hasn't reached the peeling skin part yet. (Oh, and I didn't google that, we've recently studied SJS in my nursing pharmacology course.)

The diarrhea could be accounted for as a simple side effect of antibiotic use.

*Puzzlement*

Wendy

CO EMT-B

Posted (edited)

What does his nasal mucosa look like.

No trail marks noted? (including feet)

Im still not ready to rule out drug abuse

Has the house had any recent work done.(cleaning of course) was this because of some kind of plumping or recent water damage?

any petechiae?

Edited by runswithneedles
Posted

This sure sounds like the red as a beet, mad as a hatter, dry as a bone, hot as a hare syndrome.

Posted

What part of the country are we in? Any known tick, mosquito or other insect bites?

Southeast USA. You ask the patient and he says that he has not been bitten or noticed any difference in his bodily appearance, such as a rash.

whats the family history?

Family history- HTN appearance and older age and some history of diabetes. Thats it.

You said it was a professionally cleaned house... recently cleaned? Exposure to cleaning agents? Just a thought.

I'm curious... could this be an atypical presentation of Stevens-Johnson Syndrome? The flushed red skin fits, and if he's got the rare zebra of a lesion on the myocardium, that could account for the chest pain... SJS is associated with antibiotic use, including 'cillins... may be he hasn't reached the peeling skin part yet. (Oh, and I didn't google that, we've recently studied SJS in my nursing pharmacology course.)

The diarrhea could be accounted for as a simple side effect of antibiotic use.

*Puzzlement*

Wendy

CO EMT-B

Glad I have intrigued so many of you.

House stays spotless cleaned once a week but the cleaner makes sure that adequate ventilation is being used at all times during the cleaning process to filter out the fumes and she cleans up all residues.

I have the answer to this, but am not ready to give it just yet. I would like to see what else is coming down the pipes.

What does his nasal mucosa look like.

No trail marks noted? (including feet)

Im still not ready to rule out drug abuse

Has the house had any recent work done.(cleaning of course) was this because of some kind of plumping or recent water damage?

any petechiae?

Normal nasal and mucous membranes. No track marks noted. No recent work done. The mother always wants her house clean so she has someone come in and clean it for her. No petechiae. Sorry.

This sure sounds like the red as a beet, mad as a hatter, dry as a bone, hot as a hare syndrome.

Does sound like it but not giving any clues just yet.

I inserted my foot in my mouth. He did have abnormal lab values. His T3 and T4 are elevated. I apologize for the mistake.

Posted

Ok then... any exopthalmos? He's got a thyroid storm of some sort occurring. Could have been triggered by any number of things... boyo needs some Lugol's and supportive care at this point. Fluids, cooling, quiet environment, punt to higher level provider than me...

It would explain the increased metabolism (can't get full), hyperthermia, flushed skin, agitation, and diarrhea.

Wendy

CO EMT-B

Posted

He's got a thyroid storm of some sort occurring

That is my actual medical thought too

Although possession by the devil is still a distinct possibility

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