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Case Study: The Stevens-Johnson Syndrome

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On 10/30/17 my co-worker Wendy Lavin attended the appointment with Mr. Naylor and Dr. Najjar. Per Ms. Lavin, Dr. Najjar said the Stevens-Johnson Syndrome was a mild case and the cause was the Sulfa antibiotics he took for the infection in his right index and middle fingers. The wound to the fingers was filled with moist necrotic tissue so he ordered a Santyl cream to debride the wound bed. Mr. Naylor was instructed to cleanse the wound with warm soapy water, apply the Santyl and then cover with a bandage. Mr. Naylor was instructed to continue with the antibiotics provided to him from his discharge at Genesys Hospital. He was also to follow up with Dr. Dass Orthopedic hand specialist on 11/1/17.

On 11/1/17 Wendy Lavin attend ed the appointment with Mr. Naylor and Dr. Dass. Dr. Dass said he would not need any surgery or formal hand therapy. He showed Mr. Naylor some home exercise to increase the range of motion to the fingers. He agreed with the course of treatment outlined by Dr. Najjar.

On 11/6/17 I spoke with Mr. Naylor and reported he was doing really good. He said the fingers are healing and the bumps he had are almost gone. I confirmed he did not need a
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Naylor texted me to let me know he was in the emergency room at Sparrow hospital. He reported he has had right side pain and they are ruling out passing a kidney stone or having appendicitis. He asked me to cancel the appointment with Dr. Dass and make a new one. I contacted Dr. Dass office at 455pm. I was told in Flint the next appointment with Dr. Dass is on 1/8/18, or we could go to the Fenton location on 12/15/17. I asked if he could be seen sooner by one of the physician assistants. I was told since the appointment was with Dr. Dass it had to stay with him. I took the appointment on 12/15/17. Mr. Naylor confirmed he had passed a kidney stone. He is aware of the appointment. I have reminded him to use warm water and exercise his finger as directed by Dr.
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