Contemporary

Down with viral infection

Brragh…

currently complaining of:
1. muscles and joints pain
2. intermittent body aches
3. intermittent headaches with throbbing feeling
4. chills and sweats (also intermittently, i think…)
5. general weakness
6. annoying day with all of the descriptions stated as above

Drugging myself with:
1. 2 Paracetamol tablets
2. 2 more Paracetamol tablets after 3 hours
3. What more can I say? the magic tablets-> 2 more paracetamol tabs
4. Fluffy pillows and a good comforter to tuck in… zZz
So I went to a friend to get him to get my blood… just to “have a look”… next thing i know:

Boy, it was one blood-taking-gone wrong. Oh well, a rotten day afterall, so what if I’ve got those bruises if the next thing i know I may get worse bloody problem.

Blood count came back and I’ve just got raised lymphocytes, suggesting some viral infection.. *phooh* no bigga deal. Hurrah!

Meanwhile, my w/board instructor had just gone down to Singapore and sent me this:

Absolutely exhilarating event coming up this weekend at Kallang Singapore. Shucks! Could have gone down to the island and be the dock-girl… but yours truly being down with the inevitable, thought for the better; that is not infecting those S’porean souls with this unknown virus of mine.

Anyway, whoever’s interested may go down have a look, say hi to the competitors, say hi to those cool boards displaying there and of course, go have a try at the rope. Could be the next best thing in ya life, aye!

Clinical note

Case 1

Imp: Meningitis, viral/bacterial
Clinical insufficiency: Pt refused lumbar puncture (LP) for infection diagnostic
Treatment:
1. IV Acyclovir 400mg TDS
2. IV Cefoperazone 2g BD

Pharmaceutical Care:
1. Tx w Acyclovir was initiated till day3; restarted again on Day5 (equivalently missed 4 doses). In any case, if resistant occur when patient’s vitals and health deteriorate, what will be the next Tx in line? What with the limited evidence to show that viral meningitis has a straightforward medication to treat, let it be Herpes Virus Simplex (HVS) infection to be treated now. This is clinically rational as patient had refused LP for further diagnosis.
- IF acyclovir 400mg TDS was unable to improve patient’s clinical signs, addition to (investigational) FBP and C&S negative results, FOSCARVIR (foscarnet) 40 mg/kg q12h (renal insufficiency pt) Equivalent to 40 mg/kg q8h.
- bedrest, hydration, monitor electrolytes
- Cefoperazone 2g bd continued for any prevention of risk for bacterial infection
- Both anti-infectives to be used for a period of 10 days