{"text":"~ \nv \nt \n\\ \nSei-Gateway - Clelland, Agnes M, CHI: 0809555328, 23-Feb-201 1, Respiratory Medi... Page 2 of 6 \n1 \n. CLINICAL INFORMATION \nI_-Ilstorlv of presenting complalnt \n| Presenting complaint \n\u2018Description: Cough ? psittacosls \nComment: This 55 year old fady Is troubled with an unproductive cough and shortness of breath on exertion. This has\u2019 \n. * been persistent over the past three months or so and by her account seems to have started fairly soon after \ngoing up Into the loft of her house to get some Christmas decorations down. She tells me that she has nesting \nstariings In the loft and there are coplous amount of droppings there. She does also keep a parrot, whom I am \npleased to teli you seems to be keeping well itseifl She Is a non smoker and works as a school cleaner. She \nhas had no worrying symptoms such as haemoptysis or welght loss. She has had documented psittacosis n \n1993 and she Is Type Il diabetic, . \nHer Initial lliness started with a persistent cough assoclated with some sweating on exertion and a-headache \nwhen coughing. Initially there were scattered course rhonchi on examination, but recent chest examination \nhas been-unremarkable. . . \nA chest x-ray has been reported as normal with no prei;lous chest x-fays for comp\u00e9rlson. Bloods have shown a \nrecent elevation In her ESR of 36 with a normal CRP. Chlamydia IGG is present and she Is low positive for \nChlamydla IGA. . \nGiven her persistent symptoms desplte treatment so far of Azithromycin, Ambxi'clllln and Clarithromycin we \nwould welcome your review. . \nMany thanks, \nYours sincerely \nReason for referral \n-] Care type requested: Out Patlent \nExpected outcome: Not Specified \npast medica; hisfory 7 \u2019 . \nPre-existing conditions (H!gh_ & medium priority - all) \u2018 . \npescipon . Comment B mggmez;\ufb01!\u2018gff\ufb01fm \nRecurrent and persistent NEEDS REFERRED IF UTI \/ FRANK . '22-Feb- 22-Feb- \nhaematuria \u2018 - HAEMATURIA; microscopic _ 2011 201 \n| (DJHeartburn - + reflux o ' - - %g-lbgay- ggi\u2019gay' \n. Sore throat NOS ) i ) - : ' Recurrent ggl'gay\" 'ig%ay\u2018 \nLump In breast - + 2 months history- 12 o'c\u2019lock above Rareola. - ig-ll\\gay-' i\u2018s)-ilgay-\u201d - \n| Wrist and hand sprain NOS Wristspint - ek lzg'fgav- ;g\u2014ll\u2018gav- \nErythema muforme \u2018 Blopsy has confirmed. L . ggg;\u201c' %g;\u2019;h' \nBody @as Index 30+ - obesity S : L. - \" \u00e9gg\u2019: e \nO\/E - dermatology exam. ) reactive de\u2018,rmatosis _ | . ;gar;ov ;gggw' \nT o oot ool s e Ao \n- Erythema _multiforn;e . pos.s\u2018lble\u201c\u00bb , \u2019 ' - ggoga' ggooad' \nBody mass I'ndex 30+ -obeslty - i . ' - - ;gg;gr\u00ab \nO\/E - right foot pulses present - : \u201c 1\u2018 v - - %gg;iar\u2014 \nOJE - Vibration sense of right foot i A 20-Mar~ \nnormal | \u00b0 2007 \nhttps:\/\/www.scigw;scot.nhs.ukMyblmessage\/letter.aspx\u2018 \\ ' 24{02\/201-1 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