[2741673]
Pt suffered a traumatic amputation of his left index finger and middle finger on (b)(6). He was transported to (b)(6) hospital where he underwent reimplantation of the index finger to the long finger and subsequently with subsequent grafts. He was given cefazolin prophylaxis and subsequent ciprofloxacin prophylaxis due to use of leech therapy. Leeches were used at the nailbed area of the reimplantation from (b)(6). He was dismissed from the hospital on (b)(6). He called on (b)(6) saying that an abrasion which he developed on the tip of his thumb on that side also had developed some drainage and was given ciprofloxacin 500 mg for this. (b)(6), he went to the emergency room as he had drainage from the log finger amputation site. He said it smelled bad. He was seen in the emergency room in (b)(6) hospital. Cultures of the wound infection of the amputation site from (b)(6) hospital on (b)(6) grew aeromonas hydrophilia. The organism was quinolone (ciprofloxacin and levofloxacin) intermediate and sulfamethoxazole / trimethoprim resistant. Subsequent cultures on (b)(6) at (b)(6) grew proteus vulgaris (ciprofloxacin and sulfamethoxazole resistant) and (b)(6). Pt require hospitalization, and required 2 weeks of antibiotics (ceftriaxone iv and metronidazole po) which were continued as an outpatient. This is ongoing at date of this report on (b)(6) 2012. Dose: q4h, topical.
Patient Sequence No: 1, Text Type: D, B5