CASE Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

In April, 9% of cases submitted to The Addis Clinic required consultations by infectious disease (ID) physicians.  The Addis Clinic is grateful to have two ID volunteers on our team, ready to take these cases as soon as they are allocated.

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A 22-year-old HIV positive woman presented to a local clinician in rural Kenya with complaint of a severely infected wound on her left foot that first appeared 3 weeks prior.  She reported a long history of rash and skin infections over the previous decade, though she did not possess records of her treatment history for either her HIV or chronic ulcerations.  The pain and drainage associated with the current wound kept her from walking, which was especially problematic because as a young widow with two children, it prevented her from meeting her responsibilities.  The Kenyan provider submitted the case using the The Addis Clinic’s Adult Referral template on the Collegium Telemedicus app, and the case went to an infectious disease physician volunteer for consultation.

The ID volunteer quickly responded that given the acute nature of the wound, it appeared to be a likely bacterial infection with staph or strep, and he recommended specific antibiotic treatment for at least 14 days.  Additionally, he recommended that given the patient’s history of chronic ulcers, the African clinician should also consider leishmaniasis, buruli ulcers, TB, and maybe even cutaneous anthrax, diphtheria as potential causes.  The health worker took the physician’s advice and immediately started the patient on both an oral and IV antibiotic.  Four days after the consultation, the health worker reported back that the patient was able to walk unassisted, which was a marked improvement in her condition.

The patient will continue to require aggressive wound care, as well as further testing to determine the cause of her chronic ulcers.  However, today she is mobile and infection free in great part due to The Addis Clinic connecting a passionate frontline health worker with a generous physician volunteer.