Table 2.
Clinical, laboratory, treatment of case 2, female, 13 years old, with skin abscess and cellulitis
| Time | Aug 28th, 2023 | Sep 3rd, 2023 | Sep 15th, 2023 | Sep 28th, 2023 |
|---|---|---|---|---|
| Clinical | ||||
| Temperature | 400C | 36.5oC | 36.5oC | 36.8oC |
| Glasgow Come Scale | 15 | 15 | 15 | 15 |
| Pulse (times/min) | 80 | |||
| Blood pressure | 100/60 mmHg | |||
| Breathing (times/min) | 20 | |||
| Rale in the lungs | (-) | (-) | (-) | (-) |
| Skin | Blister rash, scattered | Blisters scab | Dry, peeling blisters | Normal |
| Other issues | Swollen and painful ankle joints, knee joints on both sides, and shoulder joints, elbow joints on the right | Ankle joints, knee joint on both sides and the right shoulder joint were still swollen | Normal | Normal |
| Liver, spleen (below costal margin) | (-) | (-) | (-) | (-) |
| Laboratorya | ||||
| Red blood cells (T/L) | 3.79 | 3.71 | 4.48 | |
| Hb (g/L) | 96 | 94 | 113 | |
| Hct | 0.285 | 0.278 | 0.337 | |
| White blood cells (G/L) | 19.4 | 14.8 | 6.9 | |
| Neutrophil (%) | 71.4 | 67.7 | 50.9 | |
| Platelet (G/L) | 186 | 577 | 257 | |
| CRP (mg/L) | 107.9 | 39.9 | 13.8 | |
| AST/ALT (U/L) | 15/18 | 19/11 | ||
| Creatinine (mmol/L) | 30 | 29 | ||
| Na/K (mmol/L) | 139/3.0 | 134/3.6 | ||
| Blood culture | Bacteria (-), TB (-) | |||
| Blister fluid | ||||
| AFB staining | (-) | |||
| PCR TB | (-) | |||
| Culture | C. violaceum ( +)b | |||
| Chest X-Ray | Pneumonia | |||
| Abdominal ultrasound | Enlarged liver | |||
| Joint ultrasound | Right knee joint effusion, right shoulder joint muscle tendon echo reduction | |||
| Treatment | Vancomycin 55 mg/kg/day combined with cefepime 150 mg/kg/day (August 28th – 29th) | |||
| Ciprofloxacin 25 mg/kg/day combined with cefepime 150 mg/kg/day (August 30th—September 28th) | ||||
aOther tests, including HIV rapid test (-), echocardiogram and cerebrospinal fluid test were all normal
bOn the antibiogram, the bacteria were sensitive to fluoroquinolones, aminoglycosides, carbapenems