Chapter 26 - Clinical Corner

A patient is brought into the emergency room with a very swollen arm. He is in a lot of pain; as you examine him, you notice what looks like a surgical scar that has not healed properly and is now surrounded with dark purple skin. He explains that he had surgery to reattach his bicep, which had been hurt lifting weights, and the site of surgery has continued to hurt. You suspect that this might be a case of gas gangrene, but there is no smell associated with wound. After examination, the patient is moved from the emergency room; the next day, you hear that he had his arm amputated and he is on long-term heavy antibiotic therapy and will be for some time. In addition, the perioperative nurse says he will be hospitalized and closely monitored for some time.

A. What condition did he have?

B. Why did you think it was gas gangrene and how would you have proven it was or wasn’t?

C. Why is the long-term antibiotic therapy necessary?

Curtis Worthy is a 13-year-old white male who has come to the clinic with his mother. After your initial workup, Curtis seems to be in good health and seems to be well developed both physically and emotionally. He has a moderate case of facial acne with several pustules and papules on his face and neck. His skin also has an oily feel to it. He seems to be handling his skin condition very well, but his mother is very concerned. She is adamant that Curtis be given a prescription for antibiotics that will alleviate her son’s condition.

A. What can you tell her about her son’s condition?

B. Would a prescription benefit Curtis?

C. What would be your overall concern about giving her a prescription?