The claimant is a 42-year old female who was diagnosed with cellulitis of the left lower extremity, bacteremia, methadone dependence, transaminitis, and hepatitis C. He had a past medical history of significant IV drug abuse hepatitis C infection and was admitted recently to Nazareth Hospital secondary to left lower extremity and ankle cellulitis. He was started on IV ampicillin via PICC line and was discharged to a rehabilitation center. It was noted that he was switched to Vancomycin.
The claimant was admitted to the hospital on 08/22/2017 due to an allergic reaction to Vancomycin, which was being given via PICC line secondary to cellulitis of the lower leg and osteoarthritis of the left ankle. The claimant underwent a peripheral blood smear on 08/23/2017. The test revealed no evidence for abnormal myeloid maturation or an increased blast population. There was no evidence of a lymphoproliferative disorder. The plan of care included Clindamycin for a total of 6 weeks therapy. The records revealed that he tolerated this antibiotic …show more content…
(Gastroenterology) on 08/22/2017. It was mentioned that the claimant developed significant elevation of transaminases with AST of 165, ALT of 472, albumin of 2.3, and alkaline phosphatase of 200. His iron was 60, iron-binding was 232 with a saturation of 25.9, and ferritin of 301.8. His HCV RNA was 3.22 (reactive). The claimant was felt to have septic arthritis and osteomyelitis. His vital signs revealed a blood pressure of 100/62 mmHg, a pulse rate of 66 bpm, a respiratory rate of 18 bpm, a weight of 118 pounds, and a temperature of 35.5. The physical examination revealed an alert and oriented claimant. His left lower extremity was swollen. His abdominal ultrasound revealed hepatosplenomegaly. He was diagnosed with elevated liver function tests. The plan of care included Hepatitis C genotype, Hepatitis A antibody, Hepatitis B surface antibody, Hepatitis C treatment, and stool
The claimant was admitted to the hospital on 08/22/2017 due to an allergic reaction to Vancomycin, which was being given via PICC line secondary to cellulitis of the lower leg and osteoarthritis of the left ankle. The claimant underwent a peripheral blood smear on 08/23/2017. The test revealed no evidence for abnormal myeloid maturation or an increased blast population. There was no evidence of a lymphoproliferative disorder. The plan of care included Clindamycin for a total of 6 weeks therapy. The records revealed that he tolerated this antibiotic …show more content…
(Gastroenterology) on 08/22/2017. It was mentioned that the claimant developed significant elevation of transaminases with AST of 165, ALT of 472, albumin of 2.3, and alkaline phosphatase of 200. His iron was 60, iron-binding was 232 with a saturation of 25.9, and ferritin of 301.8. His HCV RNA was 3.22 (reactive). The claimant was felt to have septic arthritis and osteomyelitis. His vital signs revealed a blood pressure of 100/62 mmHg, a pulse rate of 66 bpm, a respiratory rate of 18 bpm, a weight of 118 pounds, and a temperature of 35.5. The physical examination revealed an alert and oriented claimant. His left lower extremity was swollen. His abdominal ultrasound revealed hepatosplenomegaly. He was diagnosed with elevated liver function tests. The plan of care included Hepatitis C genotype, Hepatitis A antibody, Hepatitis B surface antibody, Hepatitis C treatment, and stool