Jump to content
DwayneEMTP

27 year old man that's "all muddy inside!"

Recommended Posts

Isn't Arsenic used in the processing of gold??? I know you said he's an accountant or numbers dweeb,

just thinking outside the box.

S&S of arsenic exposure.

Share this post


Link to post
Share on other sites

Isn't Arsenic used in the processing of gold??? I know you said he's an accountant or numbers dweeb,

just thinking outside the box.

S&S of arsenic exposure.

Yeah man, excellent question. It is, and lots of it. But that's not it either.

And for the record, this is one of those scenarios that pisses many people off because 'they never happen.' Four hours to the closest hospital, I'm the highest level of care on scene, no chance of a chopper, and high winds have misaligned the satellite dishes so there are no phones. For some reason there was internet, and I used the hell out of it.

The first thing that I did was Google the materials used in gold and copper mining...No love there...

Share this post


Link to post
Share on other sites

Concerning the comment not aware of any bites or stings, are you sure that he wasn't harpooned with a blow gun in that area? Just joking. I am still formulating an opinion, but I can see your pucker factor is a little on the high side with this. Keep going.....

  • Like 1

Share this post


Link to post
Share on other sites

I'm going with Kuru.

Either that or his lack of mobility has produced an embolic CVA.

Could you explain why you chose to go with that?

And no, no blow gun injuries noted... :-)

Share this post


Link to post
Share on other sites

A vector borne illness is always something that needs to be ruled out. Malaria is always at the top of the list.

Edit: Obviously many others to consider or even something a bit more bizarre such as tick paralysis. You said you didn't strip the guy, did you do a detailed exam at some point?

Edited by chbare
  • Like 1

Share this post


Link to post
Share on other sites

I have to say amigo, I am glad he is your patient and not mine.

Since you have established that this is as vectored disease it rules out liver flukes, Amibiasis, Schistosomiasis and trichinosis.

I am interested by the fact that he feels "muddy" inside. This is why I would think of liver flukes, Schistosomiasis and trichinosis as parasitic infestations of the blood make you feel yucky.

What kind of house does he live in? Is it a concrete roofed house? A hut?

Does he live close to cattle?

Does he sleep with his windows open?

Does he have enlarged lymph nodes?

My first thought was to cisticercosis from under cooked pork because the worms can lodge in different tissues including the brain.

His neurological abnormalities makes me think it is secondary to something else. I am thinking that it is a disease or combination of diseases that can affect all internal organs.

I assume he has liver pain because he keeps grabbing at his right side. Did you palpate his liver? Is it enlarged? Does he have liver pain on palpation?

You guys have any Japanese Encephalitis over there?

Any chance he has Trypanosomiasis?

I am gonna have to consult with my pillow before I get a good "feel" for this one.

Edited by DFIB

Share this post


Link to post
Share on other sites

Before I give my thoughts and reveal the answer, I will say this I have been chatting with Dwayne on this matter and to tell you the truth there are some alarming symptoms that presented in his scenerio that it took me a while to catch onto. I will be honest I went through a long list of DD's before I came up with the answer to this one. Good presentation Dwayne.

My first knee jerk was heavy metal poisoning, but there was no nausea, headache, or vomitting. Then I read the scenerio again and the fact that these folks stand on a concrete floor for very long periods of time, without a lot of movement, had me considering DVT's. But from what I gathered this guy was not c/o pain any where. There were a few others like K+ deficiancy/depletion, but the EKG was normal.

Then I read the scenario over, probably about 6 times to say the least, and something hit me like a lead baloon, actually a couple of things (not to mention the area Dwayne is in is known for this particular ailment). Then I had this statement: me: I don't suspect vector borne illness cuz there is no fever unless he is having re-occuring fevers just not at time of his visit....

12:24 PM but I am sure that you would of stated that fact

Dwayne: Nice!!

The patient had a form of malaria that could kill you he had Malaria Plasmodium falciparum (which is the only variety that is known to cause death). This variety of malaria (if left untreated) crosses the blood brain barrier causing...what this guy actually had....cerebal malaria. CHBARE, you were spot on, just did not say the flavor.

Dwayne asked me to share this site with you, for those of you that wanted to read more on it. http://www.davidson.edu/academic/psychology/ramirezsite/neuroscience/psy324/rebergner/what_is_cerebral_malaria.htm

Good case Dwayne, :beer:

MongoMedic

  • Like 2

Share this post


Link to post
Share on other sites

Pretty cool. I had never heard of cerebral malaria. How did you come to the diagnosis?

Share this post


Link to post
Share on other sites

Before I give my thoughts and reveal the answer, I will say this I have been chatting with Dwayne on this matter and to tell you the truth there are some alarming symptoms that presented in his scenerio that it took me a while to catch onto. I will be honest I went through a long list of DD's before I came up with the answer to this one. Good presentation Dwayne.

My first knee jerk was heavy metal poisoning, but there was no nausea, headache, or vomitting. Then I read the scenerio again and the fact that these folks stand on a concrete floor for very long periods of time, without a lot of movement, had me considering DVT's. But from what I gathered this guy was not c/o pain any where. There were a few others like K+ deficiancy/depletion, but the EKG was normal.

Then I read the scenario over, probably about 6 times to say the least, and something hit me like a lead baloon, actually a couple of things (not to mention the area Dwayne is in is known for this particular ailment). Then I had this statement: me: I don't suspect vector borne illness cuz there is no fever unless he is having re-occuring fevers just not at time of his visit....

12:24 PM but I am sure that you would of stated that fact

Dwayne: Nice!!

The patient had a form of malaria that could kill you he had Malaria Plasmodium falciparum (which is the only variety that is known to cause death). This variety of malaria (if left untreated) crosses the blood brain barrier causing...what this guy actually had....cerebal malaria. CHBARE, you were spot on, just did not say the flavor.

Dwayne asked me to share this site with you, for those of you that wanted to read more on it. http://www.davidson.edu/academic/psychology/ramirezsite/neuroscience/psy324/rebergner/what_is_cerebral_malaria.htm

Good case Dwayne, :beer:

MongoMedic

I had my suspicion but didn't want to give it up as I had to deal with a case of P falciparum a few years back. I've often heard malaria called the great imitator and I'm a believer. Great case, much appreciated.

Share this post


Link to post
Share on other sites
This thread is quite old. Please consider starting a new thread rather than reviving this one.

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...