Age: 10.0
Sex: F
Vaccine: COVID19-2, TYP
Symptoms: Peripheral coldness, Platelet count normal, Protein total normal, Prothrombin time shortened, Pruritus
Clinical narrative: Received typhoid vaccine and COVID-19 booster on 01/16; experienced aching and left arm soreness on 01/17. Developed LUE and LLE pain on 01/18 as well as a cool feeling in LLE. Developed RLE pain, cool feeling in LLE lasting five hours, and intermittent fever to 101.6F on 01/20 managed with acetaminophen and ibuprofen. Denies any symptoms in R arm. Avoiding movement due to pain to point that family have rented out wheelchair to help her get around; won't use left leg and left arm. 1/20/23 reporting that she was itchy everywhere, also would complain she would get hot. Cheer coach said she did well at practice on 01/18 despite pain.   1/21: ketorolac 18 mg IV q6h and acetaminophen 500 mg q6h was started and continued.  1/22: She continues to have pain in her legs bilaterally and has difficulty ambulating on her own.  1/23: Mild improvement in patient's ability to use her LLE. Patient is now able to move her L foot and did slowly bend her knee yesterday as well. Patient allowed mom to lightly massage the foot as well. Reports patient was able to get better sleep overnight compared to earlier on in the weekend (less groaning secondary to pain). Patient anxious to get home and wanting to no longer be in the hospital. Afebrile in the hospital up to writing this document 1/23/23 @1334.  WBC: 7.4 k/cumm (01/20/23 23:49:00)  RBC: 5.24 million/cumm (01/20/23 23:49:00)  Hgb: 14.4 GM/dL (01/20/23 23:49:00)  Hct: 42.6 % (01/20/23 23:49:00)  MCV: 81 fL (01/20/23 23:49:00)  MCH: 27.5 pg (01/20/23 23:49:00)  MCHC: 33.9 GM/dL (01/20/23 23:49:00)  RDW: 13.6 % (01/20/23 23:49:00)  Platelet: 293 k/cumm (01/20/23 23:49:00)  MPV: 7 fL (01/20/23 23:49:00)  Neutrophils %: 35 % (01/20/23 23:49:00)  Lymphocytes %: 52 % (01/20/23 23:49:00)  Monocytes %: 10 % (01/20/23 23:49:00)  Eosinophils %: 2 % (01/20/23 23:49:00)  Basophils %: 1 % (01/20/23 23:49:00)  Absolute Neutrophil: 2.6 k/cumm (01/20/23 23:49:00)  Absolute Lymphocyte: 3.8 k/cumm (01/20/23 23:49:00)  Absolute Monocyte: 0.8 k/cumm (01/20/23 23:49:00)  Absolute Eosinophil: 0.2 k/cumm (01/20/23 23:49:00)  Absolute Basophil: 0 k/cumm (01/20/23 23:49:00)  Sodium SerPl QN: 141 mmol/L (01/20/23 23:49:00)  Potassium SerPl QN: 3.8 mmol/L (01/20/23 23:49:00)  Chloride SerPl QN: 106 mmol/L (01/20/23 23:49:00)  Carbon Dioxide SerPl QN: 23 mmol/L (01/20/23 23:49:00)  Anion Gap: 12 mmol/L High (01/20/23 23:49:00)  BUN SerPl QN: 13 mg/dL (01/20/23 23:49:00)  Creatinine SerPl QN: 0.48 mg/dL (01/20/23 23:49:00)  Glucose SerPl QN: 85 mg/dL (01/20/23 23:49:00)  Calcium Total SerPl QN: 9.9 mg/dL (01/20/23 23:49:00)  Phosphorus SerPl QN: 4.7 mg/dL (01/20/23 23:49:00)  Alkaline Phos SerPl QN: 280 Units/L (01/20/23 23:49:00)  ALT SerPl QN: 20 Units/L (01/20/23 23:49:00)  AST SerPl QN: 25 Units/L (01/20/23 23:49:00)  Bilirubin Total SerPl QN: 0.4 mg/dL (01/20/23 23:49:00)  Total Protein SerPl QN: 7.3 GM/dL (01/20/23 23:49:00)  Albumin SerPl QN: 4.7 GM/dL (01/20/23 23:49:00)  Magnesium SerPl QN: 2 mg/dL (01/20/23 23:49:00)  CK SerPl QN: 53 Units/L (01/20/23 23:49:00)  TSH 3rd Gen SerPl QN: 8.503 mcU/mL High (01/21/23 00:46:00)  T4 Free Direct SerPl QN: 0.9 ng/dL (01/21/23 00:46:00)  Folate SerPl QN: >23.0 (01/21/23 00:46:00)  Vitamin B12 SerPl QN: 447 pg/mL (01/20/23 23:49:00)  PT: 10.3 seconds (01/20/23 23:49:00)  INR: 0.91 (01/20/23 23:49:00)  aPTT: 33.4 seconds (01/20/23 23:49:00)  - U/S left venous Doppler without DVT  - CTA LLE with contrast without acute abnormalities