Case Study#1  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19   Present Illness A 37 y.o. white male was admitted with left upper quadrant pain of 2 weeks duration, diarrhea for 3 days, low grade fever, weight loss, malaise, chills, dizziness on standing, poor p.o. intake, and odynophagia to both liquids and solids of 1 month duration. PMH: IDDM diagnosed at age of 13years ESRD Cadaveric renal transplant in 7 years PTA 2d cadaveric renal transplant in 3 years PTA Pancreatic transplant 3 years PTA, rejected almost immediately MI in 7 years PTA Peptic ulcer disease 2ary hyperparathyroidism parathyroidectomy in 4 years PTA Peripheral vascular disease multiple AV grafts, left small toe amputation Tenchhoff catheter placement, then removed L femoral posterior-tibial bypass grafting (3 years PTA) Pericarditis pericardiectomy in 4 years PTA Most recently, treated for osteomyelitis with IV antibiotics, noted oral thrush last several weeks Medications: FK506 3mg bid Cellcept 1g bid Insulin NPH 70IU/Regular 10 IU a.m., 10 IU/10IU p.m. Pepsid 20 mg po qd Bactrim ss 1po qd Ca (CO3)2 500mg po tid Rocalcithol 25 mg qd Propulcid pm bid Prednisone 5 mg po qd