Quote:
Originally Posted by ender18d
What do we know so far?
Patient 1:
Cold Symptoms
Fever
Non-blanching petechial rash
Slight Headache
Patient 2:
Cold Symptoms
Fever
Altered Mental Status
Headache
(important sign no one has asked about)
Patient 3:
Cold Symptoms
Fever
Headache
Purpural Rash
Altered Mental Status
(important sign no one has asked about)
Its probably contagious, and it seems to be moving fast. Can you make a differential?
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We did ask about headache - you stated when presenting the next 2 patients, "will give you all of the questions you have already asked" so I didn't repeat it.
The headache, fever and purpura raises concern a neisseria meningiditis outbreak - any nuchal rigidity noted in patient 2 and 3?
I would assume all troops have been vaccinated and have responded appropriately to the vaccine, however, so this is lower on my differential.
My top 2 bugs are:
Salmonella typhi
Neisseria meningiditis
Both can be spread to close contacts when sanitation is substandard and can cause the constellation of findings in these troops.
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"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
Last edited by PedOncoDoc; 12-10-2013 at 16:12.
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