Peru: Policlínico Peruano Americano

Neyra de la Cruz Isabel

49 Years Old

Mrs. Neyra de la Cruz Isabel is a 49-year-old woman who visited the Policlínico presenting with a cough for a week, in addition to nasal discharge, difficulty breathing, and generally feeling unwell. The patient reports not
having had treatment previous to this consultation, assuming that her symptoms would soon pass. The medical examination provided Mrs. Neyra de la Cruz Isabel with a diagnosis of acute bronchitis.

Treatment:

• Procaine benzylpenicillin 100,000,000 and dexamethasone 4 mg/2 ml and chlorpheniramine 10 mg/ml intramuscularly every 24 hours for 3 days
• Nebulization with fenoterol 5 drops and 4 cc of physiological serum, 3 sessions of 10 minutes every 20 minutes every 24 hours for 3 days

On the second day of medication, Mrs. Neyra de la Cruz Isabel came to the Policlínico for her second nebulization, after which she followed up with the doctor, who observed improvement. The patient has been advised to continue with treatment and return for a follow-up.

Valle García Cesar

64 Years Old

Valle García Cesar is a 64-year-old man who visited the Policlínico on September 21, 2017 presenting symptoms of severe chest pain and headache. He is a dedicated welder of metal structures, and his workshop is just a few doors away from the Policlínico; he is a helpful and cordial neighbor. The patient has a history of arterial hypertension for several years and has been treating with captopril 25 mg and enalapril 10 mg. At the vital signs examination, the patient’s blood pressure was recorded at 130/90 mmHg. At the medical examination he was found to have arrhythmic heartbeats, for which he was administered captopril 25 mg (2 tablets slotted) sublingual STAT. When there was no improvement, immediate hospital admission was indicated for emergency treatment, as it presented a diagnosis of cardiac arrhythmia and ventricular fibrillation. The following day the patient visited the Policlínico again with the diagnosis confirmed by the specialist in cardiology together with the treatment indicated by the same specialty in the San Juan de Dios hospital in Pisco since he had SIS insurance.

Upon his secondary examination of vital signs, the patient’s blood pressure was at 100/60 mmHg and presented without his initial symptoms. Carrying out the immediate treatment for the critical patient made it possible to arrive at an accurate diagnosis at the opportune moment. 

Perez Estela José

51 Years Old

Mr. Perez Estela José is a 51-year-old man who visited the Policlínico presenting with stinging in the upper limbs (hands and arms) and lower limbs (legs and feet) for about 1 week. For these symptoms, the patient was prescribed treatment in the post of San Clemente without any improvement.

At the medical examination, signs of phlogosis (inflammation) were evaluated, scaly lesions on both arms and legs were found, as well as multiple continuity solution without active bleeding on the hands. The patient was diagnosed with cellulitis of the left foot, allergic dermatitis, and acariasis.

Treatment:

• Ceftriaxone 1.5 g, dexamethasone 4 mg, and chlorpheniramine 1 ampoule for 2 days
• Doxycycline 500 mg and prednisone 20 mg (orally)

On the third day of treatment, after the reevaluation of the patient, the lesions had improved, and so he was told to continue with treatment and return for a follow-up at the end of the treatment.

Rangel Quichca Rivera

30 Years Old

Patient Rangel Quichca Rivera is a 30-year-old man who presented with a wound and pain in the right ear, reporting to have been bitten by a dog. The patient states that the dog is his pet, has been vaccinated, and that the bite to the ear occurred while he was playing with the animal. The doctor examined the dog bite, after which he administered wound care and placed two stitches in the ear.

Treatment:

• Cephalexin 500 mg orally, 3 times a day after meals for 6 days
• Ibuprofen 400 mg orally, 2 times a day for 4 days