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LETTER FROM STARSHIP TO GP ON RELEASE

Starship Children's Hospital
Private Bag 92924
Auckland 1001
Ph: 09 307 4949

To: Dr ***** *********

16 August 2004

Ward 24A
Orthopaedics
Re: Charlotte Cleverley-Bisman

Charlotte was admitted to Ward 24A, Starship, under the care of Prof *** **** on 17-Jun-2004 at 12:12pm and discharged on 9-Aug-2004 at 4:08pm.
The following is a summary of the admission.

Reason for Admission:
Meningococcemia

Additional Diagnoses (if any)
Other musculoskeletal disorder
Other gastro-intestinal disorder
Afebrile seizure
Significant Abnormal results:
Wound swab grew Pseudomanas and Enterococcus

Medications prescribed at time of discharge:
Paracetamol
Lactulose (5ml od)

Further Comments:
Admitted to PICU on 17/06/2004, intubated, ventilated and on inotropes.
Extubated on 23 June. While in PICU had 2 very brief generalised seizures and was loaded with phenytoin. CT showed 2 small ischaemic lesions in left frontal lobe. No further seizures since, phenytoin stopped on 11/07/2004. Transferred to ward on 24 June. Acute drop in Haemoglobin on 29/06/2004, gastroscopy performed next day, linear ulcer in oesophagus and clot in gastric cardia found.

Started on Omeprazole and Sucralfate. No further bleeding noted since. Was on TPN feeding from 30 June to 26 July to improve malnutrition. Was tolerating full feeds by time of discharge. Also had multiple procedures for debridement of necrotic tissue and skin grafting of limbs. As a result, has had left below knee amputation, right above knee amputation, right through forearm amputation and left above elbow amputation. Discharged to Wilson Home. Dr ******* ********** will follow-up from general paediatric point of view.

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