Critical Thinking Question # 3
What is your working diagnosis and appropriate differential diagnoses (DDx) list (include three DDx)?
Critical Thinking Question # 4What is your treatment plan for this patient including education, counseling, & health promotion/disease prevention?
ONE REPLY
A 48-year-old male presents to the office after being discharged from the hospital 14 days ago for community-acquired pneumonia.PMH significant for COPD and cigarette smoking. He was recovering well from CAP with minimal SOB and cough. Denies wheezing. He received both influenza and pneumococcal vaccine in the hospital. He complains of new onset diarrhea today started three days ago and feeling ill.
Additional historical (subjective) information needed is as follows:
History of Present Illness
Onset
Has the patient experienced this problem before?
Is there anyone else the patient has been in contact with that has similar symptoms?
Has the patient traveled internationally recently?
Has the patient had any changes in his diet recently?
Duration
How often is the patient having diarrhea?
Is it constant or intermittent?
Character
What is the consistency of the stool?
Alleviating factors
Is there anything that makes the diarrhea better?
Aggravating factors
Is there anything that makes the diarrhea worse?
During his hospital stay, did he receive intravenous antibiotics?
Past medical history
Does the patient have a history of irritable bowel syndrome or inflammatory bowel disease?
Does the patient has a history of Crohn’s disease?
Does a patient have a history of celiac disease?
Social History
What is his current living situation?
What are his living conditions like in regard to cleanliness?
References
Czepiel, J., Dró?d?, M., Pituch, H., Kuijper, E. J., Perucki, W., Mielimonka, A., Goldman, S., Wulta?ska, D., Garlicki, A., & Biesiada, G. (2019). Clostridium Difficile infection: Review.European Journal of Clinical Microbiology & Infectious Diseases, 38(7), 1211–1221.
https://doi.org/10.1007/s10096-019-03539-6
Schäffler, H., & Breitrück, A. (2018). Clostridium Difficile: from colonization to infection. Frontiers in Microbiology, 9.
https://doi.org/10.3389/fmicb.2018.00646
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