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Dx Challenge at BTGH, questions answered and update From: Geffrey Klein, MD (gklein@bcm.tmc.edu) Sun Oct 29 12:22:24 1995 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Madeline24@aol.com: "Re: open glottis pushing" Previous message: DuBose: "Re: Gestations*2" Next in thread: Dr. Carlos Chase: "Re: Dx Challenge at BTGH, questions answered and update" Maybe reply: Dr. Carlos Chase: "Re: Dx Challenge at BTGH, questions answered and update" Thanks for the tremendous response to my case presentation.. I will update you and answer some questions.. Dr. Copel... Urine does have bili. Serum bili normal. Stools not acholic. RUQ ultrasound completely normal. MHATP (I guess the same sensitivity as FTA-ABS) was negative. Repeat RPR was negative. No prior history of syphilis Dr. Chambers... Thanks for forwarding case to ID friend. I anxiously anticipate further differentials. Dr. Lisse... ESR was sent, but I don't recall the result off the top of my head (not in the hospital at this second). I don't think it was abnormal, though. T. Jones, KSF... No prior history of blood transfusions. She is a monogamous LAF without obvious sexual risk factor for Hep C. I will have the test repeated. Urobili was present (see above), but serum bili was normal. I will order coombs' test as her retic ct is 2.4, suggestive of lysis. I hate to admit it, but I don't have the result of a stool guaiac.. That I will get today. How might I test for Dengue fever? I will read about it today.. Dr. Chase... Will standard blood culture reveal Leptospirosis? I will order leptospira titers. Dr. Freeland... I will also send EBV titiers. Patient was taking no medication except tylenol prior to admission (elevated LFTs noted prior to starting tylenol, BTW). Dr. Peveto... Absolutely no neurologic manifestations. Might consider LP if nothing else pans out. Updated results... Preliminary reading of thick smear for malaria negative. No cultures growing anything yet. Patient spiked twice yesterday to 103 and 104.. She responded to a cooling blanket. I am hesitant to use acetominophen in this patient with her picture of liver insult. Any support for this.. Is there a better antipyretic choice? Other serologies not ready.... Stay tuned... Further suggestions welcome. Geff Klein, MD Baylor College of Medicine, Dept OB-GYN 1 Baylor Plaza Houston, Texas 77030 Tel # 713 798 7500 e-mail: gklein@bcm.tmc.edu http://www.bcm.tmc.edu/obgyn/obgyn-ce/geff.html listowner: OB-GYN-L Next message: Madeline24@aol.com: "Re: open glottis pushing" Previous message: DuBose: "Re: Gestations*2" Next in thread: Dr. Carlos Chase: "Re: Dx Challenge at BTGH, questions answered and update" Maybe reply: Dr. Carlos Chase: "Re: Dx Challenge at BTGH, questions answered and update"

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