Upper extremities infection

Contact the primary healdi care provider as soon as possible if nausea vomiting muscle pain, tenderness, or weakness fever upper respiratory infection rash itching or extreme fatigue occurs. 

PP characteristically presents with subacute lumbosacral pain, saddle anesthesia , a rapidly progressive flaccid paraparesis and urinary retention over a few days to weeks (Eidelberg et al. 1986 So and Olney 1994). The motor involvement may be asymmetric (So and Olney 1994). A thoracic sensory level may be found in some patients (Eidelberg et al. 1986), and upper extremities may be involved late in the course of disease (Said et al. 1991). The majority of untreated individuals die within a few weeks. Many patients with CMV-related PP have co-existing systemic CMV infection such as retinitis (Behar et al. 1987 Miller et al. 1990). 

HPI KO is a 57-year-old man with a history of migraine headaches and MTN who just completed a course of antibiotics for an upper respiratory infection. He had a severe migraine headache for which he took 10 tablets of ergotamine over 6 hours. He is presenting to the ambulatory care clinic with complaints of muscle cramps and numbness in his extremities. Medications Ergotamine 2 mg at onset of headache, then 1 mg every 30 minutes until headache resolution metoprolol and erythromycin for 10 days, KO has NKDA. 

Cat bites, with an estimated incidence of 5% to 15% of all animal bites, are the second most common canse of animal bite wounds in the United States. Bites and scratches occnr most commonly on the upper extremities, with most injuries reported in women. Infection rates, estimated at 30% to 50%, are more than double those seen with dog bites. ... 

Whole root Cut small pieces of root (1/4 inch [6 1/4 mm] long) and eat fresh as often as desired for upper respiratory infections. Note the above-ground plant is extremely bitter the root is not. 

A cutaneous ulcer occurs in approximately 60% of patients and is the most common sign of tularemia. Ulcers are generally single lesions of 0.4 to 3.0 cm in diameter, with heaped-up edges (Figure 24-1). Lesions associated with infection acquired from mammalian vectors are usually located on the upper extremities, whereas lesions associated with infection acquired from arthropod vectors are usually located on the lower extremities. Ulcerative lesions are almost always accompanied by regional lymphadenopathy.13... 

Knutson J.S., Naples G.G., Peckham P.H., and Keith M.W 2002. Fracture rates and occurrences of infection and granuloma associated with percutaneous intramuscular electrodes in upper extremity functional electrical simulation applications. Rehab. Res. Dev. 39 671-684. 

The upper extrerrrities are prone to acute problems such as infection and acute trauma. They are also affected by degenerative processes and overuse injuries. Because of the importance of the ability to use the hands, the physician must be alert for anything affecting the motion of any joint in the upper extremity and seek to prevent permanent disability when possible. 

Infection of the skin or other soft tissues of the upper extremities will be apparent as an acute inflammatory event with the usual signs and symptoms of pain, heat, swelling, redness, and tenderness to palpation. Infections may be localized or may be more diffuse as in cellulitis. 

Most significant in the upper extremity is an infection of the hand because this can spread rapidly through the open network of fascia and tunnels in the compartments of the hand. A localized infection of the tuft of the finger pad is known as afelon. Infections around the nails are... 

Valley fever is a syndrome characterized by erythema nodosum and erythema multiforme of the upper trunk and extremities in association with diffuse joint aches or fever. Valley fever occurs in approximately 25% of infected persons, although, more commonly, a diffuse mild erythroderma or maculopapular rash is observed. 

Miscellaneous Anxiety depression dizziness headache rash abdominal pain/discomfort gingival disorder infectious diarrhea nausea rectal pain/discomfort tooth disorder vomiting arthritis back pain myalgia lower extremity pain menstrual irregularity vaginitis influenza upper/lower respiratory tract infection fatigue otitis sleep disorder urinary tract infection. 

Xerosis with itch is present in more than 20% of patients with HIV infection, and most commonly is localized on the lower extremities.19 One study revealed the cutaneous neural tissue density within the papillary dermis and epidermis to be significantly decreased in HIV infected patients versus healthy controls.20 The study also reported significant differences in neuropeptide concentrations within HIV infected individuals. For example, calcitonin gene-related peptide (CGRP) was reduced in the epidermis in both the upper arms and legs, whereas substance P was found to be reduced only in the upper arms of HIV patients with itch. Dry skin and itch can also be induced iatrogenically via commonly prescribed medications for HIV such as indinavir etc. The standard in HIV treatment involves protease inhibitors, such as indinavir, which have been shown to induce dry skin and itch in over 40% of patients.21... 

Enlarged lymph nodes are seen in approximately 85% of patients, and may be the initial, or the only, sign of infection. Nodes are usually tender and 0.5 to 10 cm in diameter (mean 2.0 cm). Although enlarged nodes usually occur as single lesions, they may appear in groups or in a sporotrichoid distribution. The appearance of enlarged nodes in upper or lower extremities and the correlation... 

Reduning injection (Quench the Extreme Heat injection) is made from a compound herbal formula consisting of Artemisiae annuae herba (Qinghao), Lonicerae japoni-cae flos (Jinyinhua), and Gardeniae fructus (Zhizi). It is usually used to treat high fevers due to upper respiratory tract infections. 

Ventilatory impairment results from inspiratory muscle weakness, central hypoventilation, thoracic restriction, upper airway narrowing, extreme obesity, abdominal distension, and improperly fitting thoracolumbar orthoses. In NMD, pulmonary infiltrates and respiratory failure are precipitated by mucus plugging due to an ineffective secretion clearance, especially during acute respiratory infections (2,7). 

---