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AC.32. Linta Pothen - Mr Nicholas Brihman


Dr Mathias Brown

Royal Lake Hospital

Yamba Dr

Garran ACT 2605



22 June 2020

Dear Dr Brown

Re: Mr Nicholas Brihman, aged 61

Mr Nicholas Brihman, who is revisits with complaints of four episodes of severe angioedema, is being referred for regular monitoring and ongoing care.

Mr Brihman feels irritation on the left eye, sinus pressure numbness and tingling in the mouth, and swelling of the lips, throat and tongue within 3 to 4 hours after consumption a large meal. He concern this symptoms will progress to anaphylaxis. Complained of constricted airway, shortness of breath, coughing and wheezing.

Mr Brihman has tested positive for seasonal allergies yet no history of food or drug allergies. Bilateral swelling over the lips, cheeks and soft tissue under the jaw because of that difficulty closing mouth. Mild pink and watery both eyes as mild periorbital swelling and the sclera. To rule out new allergies to protein in his diet IgE skin prick test [SPT] were ordered.

SPT was performed for commercial extracts. Hypersensitivity reaction to cat dander tested positive but rest all SPT were negative. Along with his history of tick bite and angioedema after high-protein meals were confirmed a diagnosis of red meat allergy. Meantime, blood samples collected for immunoassay send which also turn positive.

Based on the aforementioned circumstances, your immediate observation and appropriate management of Mr Brahmanism health and condition would be profoundly beneficial. In case any additional information is required, please do not hesitate to contact me.

Yours sincerely

Charge Nurse


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