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Old 07-12-2011
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Eye Eye swelling

A 38 y old female arrives at EM with h/o chest pain, palpitation,dysnea. On examination u find splinter haemorrhage and periorbital edema. Past h/o is significant for a episode of nausea, vomiting, diarrhea which occured after a hunting trip with friends 2 weeks ago. Which were subsided with treatment. CK and oesinophills are elevated.What could be the diagnosis?
1. Glomerulonephrities
2. Infective endocardities
3. Leptospirosis
4. Periorbital cellulities
5. Trichinellosis
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Old 07-12-2011
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5) trichinella? hunting means consumption of wild animals not properly cooked and elevated ck and eosinophils as its invasive organism, initial prodrome of GI symptoms always seen, splinter hemorrhages is a misnomer for IE.
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Old 07-13-2011
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5. Trichinellosis

poor cooked meat cause larva seeds muscle fiber (increase ck )
hx diarrhea and vomiting and periorbital odema in 1st 2 weeks of ingestion meat

dx(muscle biopsy or serology
rx(mebendazole or albedazole)
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Old 07-13-2011
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Quote:
Originally Posted by confident View Post
A 38 y old female arrives at EM with h/o chest pain, palpitation,dysnea. On examination u find splinter haemorrhage and periorbital edema. Past h/o is significant for a episode of nausea, vomiting, diarrhea which occured after a hunting trip with friends 2 weeks ago. Which were subsided with treatment. CK and oesinophills are elevated.What could be the diagnosis?
1. Glomerulonephrities
2. Infective endocardities
3. Leptospirosis
4. Periorbital cellulities
5. Trichinellosis
yes answer is 5. Trichinellosis. Due to uncooked meat in hunting result in transmission of larva. This encysted larva from intestine migrate to muscle and produce muscle ache above features.

1. Will show periorbital swelling, pedal edema, hypertention, other features.

2. Will have splinter haemorrhage in nails, oslers node, janeways lesion and h/o iv drug abusers and dental extraction.

3. Leptospirosis will have Water or heavy rain with farming histroy and mainly due to contact with animal urine. Its not the option here.

4. Periorbital cellulities: Recent h/o of facial, dental, sinusities, ear may be present. Its not the option.
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Infectious-Diseases, Ophthalmology-, Step-2-Questions

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