Reed Phillips, MD, Pediatrics Date of Consult: 10/01/—- Reason for Consultation: Infected Finger HISTORY: Ramzi is an otherwise healthy 2-year-old Lebanese male child who had an injury to the distal failing of his right middle finger the day prior to being seen. The patient is left-hand dominant. The patient was brought to Dr. Phillips of Pediatrics secondary to worsening redness as well as infection of the nail bed.
Orthopedics consult was requested on 09/30/—- for possible paronychia. The patient at that time was having no fevers or chills and he was tolerating his antibiotic regiment well. PAST MEDICAL SURGICAL HISTORY: None other than circumcision shortly after birth. BIRTH HISTORY: Normal full-term vaginal delivery. FAMILY HISTORY: Non-contributory. SOCIAL HISTORY: Patient lives with his mother and a sibling, Father deceased. PHYSICAL EXAMINATION: Ramzi is alert, oriented, playful, and in no apparent distress.
The patient does have erythema surrounding the tip of his right distal failings, middle finger. There is mild purulence from the area. The area is minimally tender to palpation. The nail appears to be lifting off from the nail bed itself. He has good capillary refill and has good flexion and extension of that finger. ASSESSMENT: This is a 2-year-old male with paronychia. PLAN: Follow up with me at 9am tomorrow. Mother was given my pager number should the patient’s condition worsen overnight. I will be in touch with Dr. Phillips.
The three most significant absolute monarchs in European history were: Elizabeth I from England, Phillip II from Spain, and Louis XIV from France. Elizabeth I was a freak, Louis XIV was a brave king, Phillip II was an ambitious king. Elizabeth I was born in 1633 and ruled from 1558-1603, Louis XIV was born in 1638 and ruled from 1643-1715, Phillip II was born in 1527 and ruled from 1556-1598. ...