[Adult-hlh-mas] Securemail Clements

Brittany Ahmed BRITTANY.AHMED at phhs.org
Thu Aug 23 14:01:24 CDT 2018


Hello,

I have a patient at Clements on whom we wanted to get the task force's opinion.

MRN 91897375

Ferrer, Jose

Jose Ferrer is a 44 year old Filipino male physician with hyperlipidemia, hypertension, and recent admit (8/10/2018 - 8/17/2018) for fever of unknown origin suspected to be due to an infectious cause. The fevers had been ongoing for 5 weeks prior to that admission, along with chills, sweats, generalized weakness, arthralgias, and myalgias. He has had extensive travel to India, Kenya, Tanzania, Senegal, and the Philippines. He was asymptomatic while abroad, but the symptoms started on arrival to the US.

Briefly, during recent admit, he had extensive evaluation was found to + Brucella Ab IgM along with left knee arthritis (aspirated, no growth), right shoulder arthritis (aspirated, no growth), and left calf abscess that underwent I&D by general surgery. He was discharged on ceftriaxone + rifampin + doxycycline.

He was readmitted with symptoms of fever (104.6 max), loose stools, and nausea that had not improved since discharge. Antibiotics were held as it was thought that this could be adult onset Still's Disease.

Labs on admission:
ESR 100
CRP 142.6
Ferritin 45621
Fibrinogen 509
LDH 720


Heme/Onc was consulted and they will perform BM biopsy. Soluble IL-2 receptor is pending in lab.


So far, we have started him on Solu-Medrol 1000 mg on 8/22.


Thank you for review of this case!

Brittany Ahmed
Rheumatology Fellow PGY V


CONFIDENTIALITY NOTICE This message (including any attachments) is intended only for the use of the addressee(s) and may contain information that is privileged and confidential. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient or an authorized representative of the intended recipient, the use, dissemination or reproduction of this communication is prohibited and may be a violation of federal or state law and regulations. If you have received this communication in error, please destroy all copies of the message and its attachments and notify the sender immediately. The Dallas County Hospital District and its affiliated entities hereby claim all applicable privileges related to this information.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.utsouthwestern.edu/pipermail/adult-hlh-mas/attachments/20180823/8358bb83/attachment.html>


More information about the Adult-hlh-mas mailing list