Miss Sally Brown
10 Wood Street
Stillwater
Dear Miss Sally,
Sub: To provide detailed information of diagnosis and treatments
Miss Sally Brown, who was diagnosed with cat scratch disease of bartonella henselae bacteria, requires appropriate care and continuing supervision of the condition.
On 8 February 2010, you presented to the Walk-In Centre with a reddish, pus filled, infected ulcer in the right armpit following a cat scratch while playing with a pet cat eight days ago. Even though it was stinging at times, you have been presently experiencing dull pain.
On assessment, chills in the night along with headache and abdominal cramping have been reported. Apart from that, enlarged lymph nodes and anxiousness have been observed. Although your heart rate was normal, elevated body temperature (39 degrees Celsius) as well as blood pressure – 155/100, which is greater than according to your age, have been recorded.
In relation to the treatment regimen, ciprofloxacin 500mg thrice daily for 10 day has been commenced. Heat pad was applied into the affected area to relieve the pain. Additionally, education was provided regarding wound cleanliness with antibacterial soap which can be purchased from a local pharmacy.
Based on the aforementioned circumstances, ensuring medication compliance and ongoing monitoring of wound healing progression would be extremely beneficial to have speedy recovery. In case, if you noticed any deterioration of symptoms over a period, it is imperative to contact your General Practitioner immediately.
Yours sincerely,
Registered Nurse
Walk-In Centre
Stillwater
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