Infections

It's no secret that I'm interested in infectious disease to the exclusion of everything else. In some ways, this is a liability - I'm not going to be very astute in diagnosing signs and symptoms of noninfectious diseases. On the other hand, I plan to spend the rest of my life in an infectious disease specialty clinic and that's what referrals are for. So in my clinical experiences, I consider a day a success if I can find some connection to an infection in my patient.

My patient today had a pneumothorax (see description below) and nothing to indicate that little creepy crawlies might be involved. I was a little bummed - especially since one of my classmates got a patient with MRSA (methicillin resistant Staphylococcus aureus) in his lungs...she was so lucky! But in the course of the day I discovered that my patient's lung x-rays showed evidence of granulocytes which the diagnostician noted were probably due to a past tuberculosis infection. And guess what? A TB infection can cause lung changes that lead to a pneumothrorax. SUCCESS! There wasn't anything in the patient's chart to indicate that they had ever been tested or treated for TB infection, which means they may still have a latent infection. I discussed all of this with my clinical instructor and we came to the conclusion that the patient should get a ppd test and, if positive, be treated for latent TB.

See? It's all about the microorganisms.