Saturday, April 5, 2008
Princess Marina Hospital
So, I've started working at Princess Marina Hospital. This is definitely a different place from Stanford Hospital; the wards are set up differently, the diagnostic and treatment options are different, and the diagnoses that you see here are VERY different.
I've seen several fascinating cases already. Yesterday I admitted a 17 year old boy with bony pains, fevers, and loss of appetite of 4 days duration. The diagnosis? Well, his blood smear showed malaria - Plasmodium falciparum, the aggressive form you see most commonly in Africa.
Those little purple dots on the blood smear on the right are the malaria parasite inside red blood cells. The name malaria comes from the medieval Italian "mala aria," or "bad air," because that was thought to be the cause of this illness before people knew that it was actually the mosquitos in the air that were bad because they carried a nasty little parasite called Plasmodium.
Today, I admitted a 13 year old boy - anyone 13 or older here is considered "adult" - with fevers, chills, neck stiffness, and altered mental status. The results of a lumbar puncture are strongly suggestive for tuberculosis meningitis - something you don't see much of in the US.
Another patient in his 30's came in earlier this week with AIDS, profuse watery diarrhea, and shock from lack of fluids. His chest x-ray showed an incidental finding of a rare, disseminated form of tuberculosis called miliary TB - you can see the classic x-ray lung findings on this chest x-ray, which is similar to the my patient's x-ray:
Another patient in his 30's came in earlier this week with AIDS, profuse watery diarrhea, and shock from lack of fluids. His chest x-ray showed an incidental finding of a rare, disseminated form of tuberculosis called miliary TB - you can see the classic x-ray lung findings on this chest x-ray, which is similar to the my patient's x-ray:
Both the boy with meningitis and the man with miliary TB are now on 4-drug therapy for their tuberculosis.
I now have the weekend off... Tomorrow I go camping in the Kalahari Desert - the place I've wanted to visit since writing a book report on the Bushmen in the 4th grade. They say you can sometimes hear the lions exploring the campsite outside your tent at night. Luckily they don't usually take much interest in the humans in the tents. Let's hope this weekend is no exception...
Stay tuned!
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