CHIEF COMPLAINT: Abscess in bilateral axillae, seen two and a half weeks ago for the same.
HISTORY OF PRESENT ILLNESS: This is a (XX)-year-old Hispanic female with a past medical history of diagnosis of hidradenitis suppurativa, who presents here for pain in her arms. The patient states that she has had numerous abscesses drained here in the last several years. She today complains of increasing pain in her arms. She states she thinks she has had a small amount of drainage but otherwise not any overt lumps. She had no fevers or chills. She has been out of her Bactrim, but when she does take her Bactrim, she says this makes these bumps go away.
PAST MEDICAL HISTORY: Hidradenitis suppurativa. She had a scheduled surgery in April to have these apocrine glands removed.
ALLERGIES: No known drug allergies.
SOCIAL HISTORY: The patient smokes half pack a day. No alcohol or street drugs.
REVIEW OF SYSTEMS: As stated in the HPI, otherwise negative.
PHYSICAL EXAMINATION:
VITAL SIGNS: Within normal limits. The patient is afebrile.
GENERAL: The patient is a very well-appearing Hispanic female in no acute distress.
NEUROLOGIC: Alert and oriented x4.
SKIN: Pink, warm, and dry. On her axilla, she has evidence of scars from previous incision and drainage. She has some tenderness throughout her axillary area but no obvious fluctuant areas. She has only minimal amount of erythema over this area. She has no proximal lymphangitic streaking.
EMERGENCY DEPARTMENT COURSE: The patient was seen and evaluated. The patient has a history of hidradenitis suppurativa, and here, on evaluation, she has no evidence of abscesses, and therefore, we did not proceed with incision and drainage. She has been on Bactrim in the past, which has alleviated the development of these, and therefore, we will prescribe that for her today. The patient is being discharged in good condition.
DIAGNOSIS: Hidradenitis suppurativa.
DISPOSITION: The patient is discharged to home.
DISCHARGE CONDITION: Good.
PLAN:
1. The patient was instructed to take a Bactrim DS tab one p.o b.i.d. x10 days.
2. The patient is to return for increasing or worsening symptoms.
3. The patient is to follow up for surgery in April.
