Woman’s Red Forehead Becomes Cellulitis Case, VisualDx Helps ER NP Add Treatment

Daniel A., an emergency medicine NP at the Hospitals of Providence Northeast Freestanding ER, details the case of a woman with a red forehead and how he used VisualDx to understand her condition.

“34 year old female patient presented back to the emergency department after having been seen a week prior for evaluation of redness to forehead. Patient was previously diagnosed with facial cellulitis and discharged home on Bactrim DS 1 tab PO BID x10 days. On re-examination there was extensive erythema, swelling that now involved right periorbital region. After reviewing literature on VisualDX, I identified the possible source of infection. Patient had periodontal disease, poor dentition overall with tooth decay, gingivitis. Patient had mild tenderness with erythema right maxillary sinus. Patient was vitally stable with no signs of organ dysfunction at this time. Given pt was already on monotherapy with no improvement, and based on labs and physical exam findings, VisualDx recommended addition of Augmentin. Pt instructed to continue bactrim and add Augmentin for treatment of periorbital cellulitis.”

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