Marc McMillan

23 year old student

 

PC:      painful right index finger and right hand

HPC:    had been diving in the Seychelles 2 weeks ago

            bitten by a fish in right index finger

            initially only red, painful and hot finger tip

            swelling spread to palm and wrist

            then bite started oozing whitish / green pus

            started shivering, had night sweats x2

            now small necrotic area at finger tip

PMH:   DM Type I

            Dislocated left shoulder 5 years ago (due to road traffic accident)

            occasional extrasystoles, but not causing problems

            hearing impaired on right side (uses hearing aid)

            megacolon as a neonate

DHx:    insulin (long acting od, short acting tds)

            occasionally amphetamines and XTC (MDMA, Ecstasy)

FHx:     father unknown

            mother: severe RA (rheumatoid arthritis)

            brother: Huntington’s chorea

SHx:    lives in dorms

            non smoker, occasional binge drinking

            studies law and politics