Chapter 23 - Clinical Corner

Your best friend comes to you with great news; she has found a new boyfriend. You can see that she is really excited and the romance continues for several dates and then stops. When you ask her what happened, she breaks down and tells you that when she tried to take the relationship to the next level her boyfriend told her that he had contracted genital herpes several months ago from a former girlfriend. Though he assured her that they could still be intimate by his wearing a condom, she is still very fearful that she will be infected if they have intercourse. She really cares for him and wants to continue the relationship and asks your advice.

A. What do you tell her about the possible risks of becoming infected?

B. Will his wearing a condom be able to protect her?

C. Can using the available prescription medicines available for genital herpes help them be together?

Your patient was admitted to the hospital for elective cosmetic surgery. After the surgery, which went very well, it was discovered that she had a urinary tract infection with Pseudomonas. She was placed on broad-spectrum antibiotics for two days, during which she developed vulvovaginal candidiasis. By day four she showed signs of pyelonephritis and was put on dialysis. Obviously her family is distressed and does not understand how she has gone from having a simple ‘tummy tuck’ to dialysis.

A. How can you explain what has happened?

B. What is the significance of the candidiasis?

C. What are the major concerns you have regarding this patient?