Sounds in the attic

Article Abstract:

An 87-year-old woman with abdominal pain of unknown origin and suffering from an apparent gastrointestinal disorder causing general toxicity (sepsis) died of undiagnosed pneumococcal pneumonia. Pneumococcal pneumonia is caused by the bacterium Streptococcus pneumoniae and is characterized by chills, high fever, difficult and rapid breathing, severe cough and pain in the side. The patient had a history of cardiovascular disease and chronic constipation and was admitted to the hospital primarily for abdominal pain but also had been experiencing difficulty breathing. An abdominal ultrasound test found no gallstones or abdominal aneurysm. Her blood pressure dropped significantly and her white blood cell count suggested peritonitis and sepsis with shock. She was treated with intravenous fluids and antibiotics but died about 40 hours after admission. Autopsy revealed no signs of gastrointestinal disease or peritonitis. This case highlights the difficulty of diagnosing pneumonia in the elderly and the confusing nature of the disease.

Pneumonia, Pneumococcal, Pneumococcal pneumonia

---

Getting the story right

Article Abstract:

A 47-year-old man with episodes of chest pain received an extensive work-up for coronary artery disease even though many aspects of the work-up indicated that he had a low risk of having the disease. He began experiencing midsternal chest pain six weeks before admission and had been experiencing shortness of breath and fainting for several years. He had been diagnosed with urticaria pigmentosa as an adolescent. This disease is characterized by an infiltration of mast cells into various tissues. Although he had a positive stress treadmill test, a thallium-201 scan revealed no cardiac abnormalities. His chest pain worsened despite treatment with a beta-blocker. A coronary arteriogram revealed normal coronary arteries and no evidence of coronary artery spasm. Histamine blockers eliminated the pain, indicating that it had an anaphylactic component. The cause of his chest pain remains unknown, but it may be due to the infiltration of mast cells into the heart.

Chest pain

---

Costly errors

Article Abstract:

The case of a 74-year-old woman illustrates the unfortunate consequences of delayed treatment due to diagnostic errors. The patient received high doses of prednisone and weekly blood transfusions for anemia, and developed severe bone pain. The patient's osteoporosis and pain deteriorated with prednisone yet the transfusions failed to improve her blood count. Further diagnostic imaging and biopsy revealed a B-cell lymphoma. The patient rejected complex chemotherapy on the basis of further pain expectancy and died a short time later. Lack of further laboratory testing and excessive need for blood transfusions may have been responsible for this mistaken diagnosis. Furthermore, the therapeutic failure of prednisone should have prompted alternative diagnostic methods.

Anemia, Causes of, Complications and side effects, Diagnostic errors, Lymphomas, Prednisone

Similar abstracts:

• Abstracts: Seasoned advice. Eating right. Diet defeats diabetes
• Abstracts: Making it to the top. Finding out the worst. Prison support
• Abstracts: Saved by the pig? Every woman's right
• Abstracts: Fresh outlooks. Catheters: making the right choice
• Abstracts: No doctor in the house. A haven in hell. Professional services

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.