By Tedler D. Depaynos, MD
The patient is an elected official in a nearby municipality who went to the south as one of the delegates to attend the anniversary celebration of a “sister” municipality. They were much impressed and the adventure was a very valuable learning process. They were well cared for by their hosts.
On their last night while waiting for their flight back home, they thought of visiting a noisy “bar” located just in front of their hotel. Anyway with their excitement, sleep seemed to be unfriendly despite their exhaustion due to their tight schedule. The “bar” experience was a relaxing one and they all fell contented as they boarded their scheduled flight and snored along the way.
It was just the following day when the patient began to experience “itchiness” in both his anterior wrists. He started applying “alcohol” allegedly to “disinfect his arms” and he noticed that he felt relieved when he exposed them to heat from the hot shower. The following day, his hands appeared swollen and the itchiness was spreading fast all over his body. Painless papules and vesicles which looked like “chicken pox” lesions followed the itchiness. He started puncturing the lesions and although some appeared to be drying up, the spread was uncontrolled. He consulted their MHO who gave him some anti-allergic medications and antibiotics for possible bacterial infection. Because the spread appeared too rapid, he sought confinement to isolate himself fearing that it might spread in the household especially to his “apos” or grandchildren who are fond of him. Beside his swollen hands were becoming non-functional.
Although he denied entering the “massage clinic” in the “bar” which made his attending MDs smile, he cannot definitely say if the “lady” who entertained him on their table had any skin lesions because of the dim light and effect of several bottles of alcoholized water.
The patient was afebrile and his blood tests were all within normal so that initially a viral infection was entertained especially when a study of the skin lesions was done. Both Gm staining and culture and sensitivity of the lesions for aerobic and anaerobic bacteria were negative. He was referred to an experienced Infectious Disease specialist who gave the impression just by the looks of the lesions of “Impetigo” or bacterial skin lesion. Strong doses of antibiotics were then given intravenously to avoid possible complications like cellulitis of his hands and septicemia which may be fatal. Meanwhile, debridement was done on the vesicles and antibiotic ointment was applied daily.
Improvement after a few days were apparent and when the antibiotics were shifted thru the oral route, he was discharged. The patient was adamant that the lesson he learned from his sickness was more valuable than what they observed as guests of their “sister” municipality. He kept on repeating however, that it did not come from his tabled “lady” especially in front of his wife. **
