Secure Message Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2025-07-18 Encounter: Photo review (mouth/cheek images sent by parent) followed by Spruce text message CC: Decreased appetite, irritability, neck pain, and red throat — possible hand-foot-mouth disease. HPI: Jack had been eating poorly all week, was irritable, and complained of neck and throat pain. His throat appeared red. Parent also developed large oral sores and suspected hand-foot-mouth disease in both herself and Jack. HFM was noted to be circulating. Jack's cheek photos were also reviewed. Parent had previously had HFM two years prior. Assessment: Dr. Hobbs confirmed HFM was going around and assessed Jack's cheek photos as not changing clinical management. Parent's oral sores were assessed — top sore appeared more consistent with a canker sore. Jack's lesions did not appear as severe as parent's. Plan: Ibuprofen for Jack's discomfort. OTC hydrocortisone cream (Cortaid or generic) recommended for parent's oral sores — noted that steroid cream can be applied in the mouth. Defer cortisone for Jack unless needed as his lesions appeared less severe. Medications: - Ibuprofen OTC, dose not specified - Hydrocortisone cream (Cortaid) OTC, applied topically to oral sores (for parent) Key clinical quotes: "HFM is def going around right now." "steroid cream on them can help a lot and yes, you can put steroid cream in your mouth" "If needed, but I'd hold off. He's don't look as bad as yours did" Source: Spruce conversation t_226ST10QO3800