Chapter 25 - Clinical Corner

A patient comes into the clinic for follow-up after having his spleen removed three months previously because of trauma resulting from an automobile accident. After checking to make sure that he is feeling well and healing properly, the doctor has given him a prescription for antibiotics and told him it is important that he take these before and after he visits the dentist, even if he is only going to have his teeth cleaned. He asks you why this has been ordered.

A. What do you tell him?

B. What are the potential consequences if he neglects to follow the doctor’s orders?

You are working as a physician’s assistant in a Doctors Without Borders/Médecins Sans Frontières clinic in the Democratic Republic of the Congo. Your patient is a 60-year-old white female Catholic nun who has been on a religious mission to the interior areas. She is complaining of difficulty in breathing, pain, and cramping in the groin that has been going on for about four days. Upon examination, you discover several bulging lymph nodes in the groin, some of which are suppurative and bleeding.

A. What are your initial thoughts about this patient?

B. What do you do, and how would you prevent the spread of this infection?