A 55-year-old healthy male patient, Non-smoker / occasionally has alcohol presents with complaints of bilateral ankle and foot edema, non itchy rash below the knees since 2 weeks. Recently travelled to Bihar and Kota. Occurance of mild soar throat before the rash. Previous history of singles in right thigh 5 years back. No family history. Systemic examination is normal. Local examination - The rash is macular echymotic with subcutaneous nodular feeling and tender, warm on touch.
Lab tests - low vitamin D, low B12, slight neutopenia 1% less, WBC normal. Serum sodium 113 . Treatment by previous doctor- tab.cefuroxime 500 mg bd x 5 days, tab. Fexofenadine 120 mg od x 5 days, tab.Calcium supplements od x 4 ethos, tab.Mahacort DZ 6 bd x 5 days, tab. Furosemide od x 5 days locally Miconazole once daily. These are medicines given in 2 visits by the Doctor. The first visit antibiotics did not…
