Good morning to you all...
I apologize in advance, I worked a 12 hr night and I'm sleepy, so forgive any lapses in logic here...
I had an admission last night. 89 y/o F with h/o Parkinson's disease, admitted for an acute MI and SVT.
She was a great admission, sweet as pie! Took her to the bathroom and noticed bright blood in the toilet.
I told her what I saw and she agreed to have me examine her further to identify the source of bleeding.
She denies scratching, pain, irritation, etc. No hemorrhoids. Alert and oriented x3.
I found a small, non-painful bleeding ulcer (about the size of a grain of rice?) on her labia..
looking at the whole picture, it looked like she had others which had healed. She denied tenderness
or pain while I was cleaning the area. She also denied knowledge of anything unusual going on down there..
I did order an ET consult, and I communicated this info to the docs... I hope they care enough to check it out or at least ask her PCP to run an STI panel... anyway...
What do you guys think it could have been? my guesses were HSV and syphilis... except I would expect HSV to cause some type of discomfort... also, she denies being "with" anyone since her husband died over 10 yrs ago, and I doubt late stage or latent syphilis would cause ulcerations... but the parkinsonian neuromuscular issues and the heart disease do fit... or maybe i'm just making connections that aren't there because I'm so amazingly sleepy :-P
My overactive brain has been pondering this all night...
Any of you see STI/STDs in your elderly population? This is the first time I've seen this, although I know it's been a pressing issue for the elderly population as of late.
Thanks. Sorry for the odd topic.
G'night to the nightshift folk!