Photoclinic features patient photographs submitted by office-based primary care clinicians. These images are chosen for their teaching value and seasonality, to help you recognize problems you might see in your own patients.
Persistent, purulent drainage from the perirectal region for 3 months prompted a 60-year-old man to seek medical evaluation. He also complained of minimal bleeding from the anus and perianal itching. The patient reported that he recently obtained some relief after a boil in the same area spontaneously burst.
Three days after having eaten fish, a 66-year-old woman with a known allergy to fish and a history of schizophrenia was brought to the emergency department because of macroglossia—a presentation of anaphylaxis. The patient refused airway management (intubation or cricothyrotomy) and was therefore admitted to the medical intensive care unit for monitoring of her airway and hemodynamic status. She received corticosteroids, ranitidine, diphenhydramine, epinephrine, and oxygen (via nasal cannula).