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Asked by ann1670
A 32-year-old woman presents to you with a one week history of a bump on her leg that has increased in size and is now painful. She wonders if she was bitten by a spider or insect and states the lesion started off about the size of a “pimple” but then kept getting larger. She was able to express some pus from it 3 to 4 days ago and thought it would go away but now it feels as if there is more tenderness underneath her skin—although it seems to be coming a head, she cannot squeeze out any more pus.
She has never had anything like this before, although she does note that in the past when shaving her armpits, she sometimes would have a couple of bumps or pimples but they would usually go away after a few days. She denies fevers, chills, or any additional systemic symptoms. She is an active athlete and goes to the gym for weight training and basketball 2 to 3 times a week and participates in a CrossFit program weekly.
Review of Systems
Positive for mild fatigue and leg pain. She denies any history of abdominal pain, additional rashes or lesions, nausea/vomiting, chest pain, SOB, headache, or dizziness.
Past Medical History
No report health problems.
She is a heterosexual woman who reports having 3 different male sexual partners in the past 3 months. She tells you that she had a negative HIV test and “some tests for STIs” that were also negative about 3 weeks ago. She works as a patient care associate at a local nursing home. The patient states she drinks at parties and social events, smokes marijuana occasionally, and reports no other drug use.
Family history includes both parents with hypertension.
Her only medications are daily multivitamins and oral contraceptives, and she denies any medication allergies.
Allergies—no known drug or food allergies.
Medications—Multivitamin 1 PO QD; Oral Contraceptive—she did not remember the name.
Physical Examination
Vitals: T 100.1°F, P 88, R 12, BP 110/77, WT 150 lbs., HT 65 in., BMI 25.
General: Well-developed, well-nourished woman in no apparent distress.
Skin, Hair, and Nails: A 3-cm nodule is noted on the right anterior thigh, with surrounding erythema and a shiny head. It is tender to palpation and there is moderate fluctuance noted as well. No other lesions or rashes are noted from a full skin exam. No abnormal findings with hair or nails.
Lungs: Clear to auscultation bilaterally.
Heart: RRR, no murmurs/rubs/gallops.
What is the main dx could it be? (That’s all the info that I have)
SCIENCE
HEALTH SCIENCE
NURSING
