C09994427 / invoice 10000

Appointment Notes: poss ringworm History:Suspects RW - O's husband was diagnosed with RW on forehead last Wednesday. Vomited las Thursday night - no further vomiting. Normal self still, bright at home.History of skin allergy - was previously on cytopoint inj but not been given for a while; giving probiotic at home. No obvious skin lesion noted by O.O would like to give cytopoint inj for licking. Historically healthy, not on any medication. Examination:BAR, euhydrated, BCS 5/9Fur intact, skin on top of head and around neck erythemic; no obvious active lesion noted on body; saliva staining on all 4 paws; interdigital skin erythemic and slightly thickened with no discharge/ulceration No ectoparasite detected Laboratory:Woods lamp -ve Assessment:Skin allergy Suspects RW - no obvious lesion detected; woods lamp -ve Treatment:1. Cytopoint 20mg given SCComm/plan:1. Relayed findings and advised O cannot rule out RW infection - offered fungasay but warned O of false negative results (as no area of interest detected) - O understood and declined culture, opted to start on treatment 2. Terbinafine 250mg PO SID for 28 days - advised O RW infection may take longer than 4 weeks treatment - O understood and opted to start with this 3. Malaseb wash BIW for 4 - 6 weeks - O got shampoo at home 4. Cytopoint booster in 1 month or when skin flares up 5. Recheck in 3 - 4 weeks, sooner if noticed skin lesion     Vital Signs    Weight: 10.2;