She has SLE.

She has has the rash associated with SLE on her chest/face

She swims/surfs and gets a lot of UV rays.

Could it be because she swims? To prevent some infection?

Does it have something to do with swelling of some female genital part?

I'm dry on ideas. I cannot figure out the indications for flagyl.

Here is a file of the pretend pt case

thanks.

(As far as the Nexium goes, I said because the lupus could cause swelling of the esophogus and that could cause back up acid)

Scenario 2.docx

I would guess it's to prevent/treat infection due to the blistering lesions. Her WBCs are high, which suggests there might be an infection. Flagyl is indicated for skin & skin structure infections.

Metronidazole (Metrogel) is commonly prescribed for Rosacea as an anti-inflammatory. I could understand why the topical form would be prescribed for the SLE rash, but not oral.

Was the Flagyl/metronidazole oral or topical?

it is also used as antibiotic in mucosa, like the gut

Flagyl isn't mentioned in the scenario you provided. IS this patient on any meds for the lupus? There has been some anecdotal evidence that the antibacterial of flagyl has proprieties act similar to the properties of the antimalarial drug Plaquenil which is used in auto-immune/rheumatic diseases

She has SLE.

She has has the rash associated with SLE on her chest/face

She swims/surfs and gets a lot of UV rays.

Could it be because she swims? To prevent some infection?

Does it have something to do with swelling of some female genital part?

I'm dry on ideas. I cannot figure out the indications for flagyl.

Here is a file of the pretend pt case

thanks.

(As far as the Nexium goes, I said because the lupus could cause swelling of the esophogus and that could cause back up acid)

This patient's WBC count is high. If you didn't recognize that, go look it up. What does a high white count indicate? If you said infection, you'd be correct. It would appear to me that this patient has an infection of some sort, and the Flagyl is being used to treat the infection.

In my experience working with ob/gyn, Flagyl was often used to treat BV, or bacterial vaginosis. Irritation, swelling, and malodorous discharge are common symptoms.

Flagyl is also used to treat c.diff/pseudomembranous colitis.

This patient's WBC count is high. If you didn't recognize that, go look it up. What does a high white count indicate? If you said infection, you'd be correct. It would appear to me that this patient has an infection of some sort, and the Flagyl is being used to treat the infection.

People with inflammatory auto-immune disorders will also have an elevated WBC from their overactive immune system attacking their body.

People with inflammatory auto-immune disorders will also have an elevated WBC from their overactive immune system attacking their body.

Yes, exactly! WBCs can be elevated in trauma situations too, it's not always an infection indicator. Inflammation or swelling can be the culprit. This occurs in auto immune diseases like Lupus.

Following botched foot and ankle surgery at the end of 2010, my husband began to have several

problems, including weird rashes, immune system issues, and one subspecialist thought possibly

a fungus, based on where he had travelled or lived earlier.

He was started on oral Flagyl, and aside from its horrible taste, had no side effects. Could your

patient have lived out of the country when her husband was in the service? Was she in the Peace

Corps.? Many Peace Corps. volunteers have returned with fungi unknown here.

I would say it's prophylactic since the only obvious infection was the acne. Protocol is to treat elevated WBCs.

Remember that Lupus is autoimmune and the body is attacking itself. It can be made worse by an infection, exaggerate the response. Get rid of the trigger, decrease the response. Sunlight can make it worse.

I think it's silly that this case study took her to the hospital, all that could have been outpatient, since what she had wasn't life threatening.

Thanks everyone. I'll post what my professor wrote if y'all want to see, once she grades it.

I noticed the WBC count, I said "possible infection" for the indication.