17-month-old boy with a small patch of erythema at the base of his penis. There is warmth, but no induration or fluctuance. He seems uncomfortable during recent diaper changes. Upon closer inspection, there is a circumferential crease-like indentation on the penile shaft. Theory: a hair tourniquet possibly causing microscopic breaks in the skin, letting bacteria in, and leading to the development of cellulitis? After a short course of keflex, the erythema has disappeared and everything is back to normal.
40-yr-old male with branch retinal vein occlusion of the L eye (his only symptom was a 2-month history of blurry vision) diagnosed by an optometrist who sent him to clinic for a full systemic disease workup, since most patients with this condition are over the age of 65. This affable man is 30 lbs overweight, drinks 6 to 10 beers daily, has smoked 2 packs of cigarettes a day for the past 20 years, and has an elevated blood pressure of 148/100. I think it's kind of obvious why he had the equivalent of a stroke in his eye. It's no surprise when his fasting cholesterol turns out to be sky high, and I send him home with a prescription for morning aspirin and a bedtime statin after politely reading him the riot act about modifying diet & exercise and cutting down on tobacco & alcohol use.
P.S. They still use demerol here! For migraine headaches! I've never seen demerol used outside of Season 3 Episode 5 of Mad Men when Betty Draper was in labor and became dreamily hallucinogenic after receiving a shot of demerol for pain...
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