The Effectiveness of Family Medicine-Driven Interprofessional Collaboration on the Readmission Rate of Older Patients

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In this case report, we describe a rare case of non-typhoidal Salmonella bacteremia in an 87-year-old woman with no apparent history of daily Salmonella exposure. The patient presented with fever, body discomfort, and diarrhea. Medical examinations ruled out usual sources of Salmonella , including raw food consumption and pet contact. Her medical history included postoperative sigmoid colon cancer, left breast cancer, and other ailments. Although Salmonella infection typically stems from oral intake, this case suggests that bacterial translocation from the gastrointestinal tract could be the primary cause, potentially exacerbated by the patient's age and medical history. Another hypothesis is an ascending infection from diarrhea to the urinary tract, which might have led to pyelonephritis and subsequent bacteremia. This case highlights the importance of recognizing the potential for severe infections such as sepsis in older individuals presenting with diverse symptoms. Therefore, this case further underscores the need for heightened clinical vigilance, especially in community hospitals, to ensure timely and appropriate management of such severe conditions in the older population.

Section: Discussionmentioning

confidence: 99%

Salmonella Bacteremia in an Older Patient With No Specific Entry: A Case Report

Kudo,

Ohara,

Sano

et al. 2023

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“…Previous research has shown that these patients can have multiple coexisting conditions that require thorough diagnostic evaluation [ 16 ]. Collaboration with a multidisciplinary team driven by family physicians can optimize patient outcomes in rural community hospitals [ 17 ]. Therefore, a comprehensive, collaborative approach is necessary to ensure optimal patient care and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Acute Onset Rheumatoid Vasculitis With Polyarthritis and Erythema: A Case Report

Amao,

Koda,

Ofuji

et al. 2023

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We present the case of a woman in her 70s who was diagnosed with rheumatoid vasculitis (RV) after initially presenting with systemic joint pain and erythema. RV, a rare complication of rheumatoid arthritis, involves inflammation of blood vessels, leading to various skin manifestations. The patient's complaints included fever, generalized joint pain, and skin manifestations that initially resembled erythema multiforme. However, a skin biopsy revealed vasculitis, which guided the RV diagnosis. Although rheumatoid arthritis primarily affects the joints, systemic implications such as RV can arise in rare cases. This case underscores the importance of a holistic and meticulous diagnostic approach, especially in older patients, as early detection and treatment are crucial for managing disease progression and associated complications. Collaborative care involving multidisciplinary teams is vital to achieving optimal outcomes in complex cases.

“…Collaboration among internal medicine specialists, nutritionists, and physiotherapists was crucial in managing her complications and ensuring adherence to lifestyle changes. This reflects a scholarly approach to clinical care [ 2 ].…”

Section: Case Presentationmentioning

confidence: 99%

“…Effectively managing RA is challenging due to the complex role of social determinants of health (SDH). These factors, including socioeconomic status, education, healthcare access, and environmental conditions, significantly affect health outcomes [ 2 ]. In rural areas, where resources and healthcare access are typically restricted, these SDHs create distinct challenges [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Integrating Clinical and Socio-Environmental Approaches in Managing Rheumatoid Arthritis With Social Determinants of Health: A Case Study of an Elderly Patient in Rural Japan

Ohta,

Sano

2023

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Rheumatoid arthritis (RA) poses significant management challenges, especially in elderly patients living in rural areas with limited access to health care. This case report illustrates an integrative approach to managing RA, emphasizing the interplay of clinical, social, and environmental factors. A 72-year-old woman in a rural Japanese setting presented with progressive, widespread joint pain, initially self-managed with over-the-counter medications. Her condition, complicated by socioeconomic constraints and limited access to health care, necessitated a comprehensive management strategy. Clinical examination revealed bilateral joint tenderness, swelling, and high titers of rheumatoid factor and anti-citrullinated protein antibodies, confirming RA. Treatment included methotrexate and prednisolone, complemented by lifestyle modifications. Interdisciplinary collaboration among healthcare professionals, including nutritionists and physiotherapists, facilitated her management. The patient's care was guided by the chronic care model and the ecological model, addressing her clinical needs and socio-environmental context. This holistic approach resulted in improved clinical outcomes and enhanced quality of life. This case highlights the importance of a patient-centered, multidisciplinary approach in managing RA in rural settings. Integrating clinical management with an understanding of social determinants and patient empowerment is crucial for effective treatment. The case underscores the need for adaptable healthcare strategies that are sensitive to the unique challenges faced by elderly patients in rural communities.