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Medical Maladies Quiz #1

04 Apr
Gregory HOUSE

Image by Alexis D. via Flickr

Okay guys! Here’s your first official Monday “Medical Maladies Quiz” entry. I will post the question, usually in the form of a clinical vignette, and you will have the chance to solve the case! Gregory House style! Minus the Vicodin of course. 🙂 Within a day or so, I will post the answer to the case along with some information and common presentations/symptoms, and common treatments for the diagnosis. This way everyone gets to learn something! Until the official diagnosis is announced, feel free to debate and discuss the possibilities. Without further ado, here we go:

Presentation:

The patient is a 45-year-old male, who had recently returned from a business trip to New Orleans. He presents to the ED about 48 hours after returning from his trip. Patient is alert upon admission, with the chief complaint being diarrhea and abdominal cramping.

The patient says that he had only been gone for about three days total and had felt fine before the trip. He admits to having had raw oysters while out for dinner on the last night there with some colleagues. Patient’s BP is slightly low, but within normal range and his HR is slightly elevated. A stool examination returns negative for fecal leukocytes. CBC blood tests return normal findings. Gram stain shows up with Gram negative, motile, curved rods.

What is your diagnosis for this patient?  Please leave your answers in the comments below!

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10 Comments

Posted by on April 4, 2011 in Medical Maladies

 

Tags: , ,

10 responses to “Medical Maladies Quiz #1

  1. Rishi

    April 4, 2011 at 9:20 pm

    Given the temporal and acute relationship between the consumption of oysters and onset of symptoms, my gut instinct is to assume food poisoning… possibly from something like cholera. I don’t think V. cholerae toxin causes a fecal leukocytosis, so that part of the history is acting against my hypothesis. I’m attributing the BP and HR to moderate dehydration secondary to the diarrhea. Looking forward to the answer! 🙂

     
    • Flustered Grad

      April 4, 2011 at 10:04 pm

      Crud. Let that be my reminder to double, triple check these before they go out. 😉 The stool examination will return a negative reading for fecal leukocytes. Put one other extra hint in the vignette too after editing.

       
  2. PA SuperTammy

    April 4, 2011 at 10:58 pm

    I’m going with V. vulnificus but it has been a few years since I took pathogenic microbiology so it is a sketchy guess. I can’t remember if it is motile and other than verifying the spelling I refuse to google it to double check.

    Thanks for your comment in my blog, I appreciate it!

     
  3. Pranab

    April 5, 2011 at 8:44 am

    The raw oysters scream Vibrio vulnificus. Mild gastroenteritis would cause the symptoms outlined. No idea about the fecal leukocytosis though! 😛

     
  4. Axl

    April 5, 2011 at 9:12 am

    Hey Flustered – Thanks for the encouragement. I’m so close yet so far 🙂 Sorry, I have no input in to this medical malady quiz – are you in med school already? How do you know about this stuff??

     
    • Flustered Grad

      April 5, 2011 at 9:42 am

      I read through case reports occasionally. The rest is a combo of microbiology, immunology, and virology courses from under grad. Oh, and Google helps fill in the gaps. 😛

       
  5. Axl

    April 5, 2011 at 9:19 am

    Oops nevermind- just read over some of your older posts and I see that you are probably applying in my cycle this summer! Cool- look forward to sharing experiences in this process. So are you planning to apply MD/DO and carrib? I’m sure you’ve read Jonathan’s blog right? Lots of good lessons to be learned there.

     
    • Flustered Grad

      April 5, 2011 at 9:44 am

      I had not. I’ll Google that this afternoon and take a look. Thanks for the recommendation!

      EDIT: I have read a little bit of one of his blogs apparently. I remember reading along with his first blog back when he was first looking to get into medical school. I didn’t even know he had another two blogs.

       
  6. schorrmore

    April 6, 2011 at 3:27 am

    Ooh this is fun! I know embarrassingly little about diseases, but I’ll still guess- could this be the notorious norovirus?

     

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