To : Hon Plastic Surgeon on call
Thank you for accepting this patient.
As you will see he has an extensive infection to his right hand from what appears to be a human bite.He is pyrexial at T39,3*C with marked tracking extending up to his bicep and he feels unwell.There is no bony injury.This is his dominant hand.
The patient reports that he was out at a club 2 nights ago , and during the course of some vigorous dancing, apparently his hand may have inadvertently got in the way of someones mouth.
He denies any history of assault and appears to regard this as some sort of spontaneous event.
There are however 16 teeth-marks around his right thumb and thenar eminence-8 on the palmar surface and 8 on the dorsum,suggestive of his hand having been bitten.
He denies this but admits that possibly he has sustained a "hand vs. mouth" injury.
He reports that he has had a similar injury in Sydney in Australia last December which necessitated a 5 day admission to St Bondi-by-the-beach for IV antibiotics and EUA.
He further reports that he was told by the Australian plastic surgeon that if he ever again sustained a "hand vs. mouth" injury that he should seek immediate medical attention .
I have naturally asked him why he has delayed care today and he is under the impression that's its only Australians who have dirty mouths.
I have therefore advised him that the "dirty mouth" that the Australian surgeon was referring too was the bacteria in the mouth and not because they had called him a "stupid , whinging Pommie bast*rd" of which he is indeed a prime example.
Kind regards
Lucien de Beer
Thank you for accepting this patient.
As you will see he has an extensive infection to his right hand from what appears to be a human bite.He is pyrexial at T39,3*C with marked tracking extending up to his bicep and he feels unwell.There is no bony injury.This is his dominant hand.
The patient reports that he was out at a club 2 nights ago , and during the course of some vigorous dancing, apparently his hand may have inadvertently got in the way of someones mouth.
He denies any history of assault and appears to regard this as some sort of spontaneous event.
There are however 16 teeth-marks around his right thumb and thenar eminence-8 on the palmar surface and 8 on the dorsum,suggestive of his hand having been bitten.
He denies this but admits that possibly he has sustained a "hand vs. mouth" injury.
He reports that he has had a similar injury in Sydney in Australia last December which necessitated a 5 day admission to St Bondi-by-the-beach for IV antibiotics and EUA.
He further reports that he was told by the Australian plastic surgeon that if he ever again sustained a "hand vs. mouth" injury that he should seek immediate medical attention .
I have naturally asked him why he has delayed care today and he is under the impression that's its only Australians who have dirty mouths.
I have therefore advised him that the "dirty mouth" that the Australian surgeon was referring too was the bacteria in the mouth and not because they had called him a "stupid , whinging Pommie bast*rd" of which he is indeed a prime example.
Kind regards
Lucien de Beer
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