A 38-year-old male consulted his family physician (FP) over the phone for chickenpox which he contracted from his son. He also complained of retrosternal and epigastric pain on swallowing. The physician prescribed omeprazole 20 mg once daily and ibuprofen over the phone, without seeing the patient. Later in the night, the man presented to the emergency department of a nearby hospital with complaints of severe retrosternal, mid-chest pain (on swallowing) that was radiating through his back for 24 h.
The physician there noted that the patient was chronically on methylprednisolone medication (8 mg once daily) for Crohn’s disease for 6 years . The vital signs showed a temperature of 38.3 o C, blood pressure of 155/110 mmHg, heart rate of 81/min, and respiratory rate of 20/min. Physical examination revealed scattered vesicles/pustules on the face , soft palate , and pharynx . The…
