Hello again, and welcome to the fifth week of The Diagnosis! Congratulations to those of you who correctly guessed Louis' diagnosis from last week's article: the wildlife photographer, who had just recently returned from a tiger safari though Sundarban, India, was suffering from a case of Dengue fever. This viral illness is carried by mosquitos through tropical regions, and in the majority of victims is no more problematic than an ordinary fever. However, about 5 percent of victims exhibit more severe symptoms, including prolonged fever (for two to seven days) extreme muscle and joint pain, and the characteristic red rash. There are no antiviral drugs on the market that specifically combat Dengue fever, but with proper hydration, Louis is able to overcome his symptoms and make a full recovery.
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This week's case surrounds an 11-year-old boy named Mason, a resident of a rural town who has spent the past three days home from school. On the first day, he complained to his father about a runny nose and sore throat. These symptoms seemed relatively unremarkable, but Mason was obviously ill, so his father conceded to let him stay home. The second day was much worse: Mason developed a high fever, body aches, and extreme fatigue. His father gave him aspirin to help bring down the fever and tried to convince Mason to eat. Unfortunately, Mason had very little appetite and refused most of the foods offered to him, but his father feared deeply about the consequences of Mason's fasting. During his newborn screening, Mason had been diagnosed with a fatty acid oxidation disorder. He was missing certain enzymes to help him oxidize fatty acids, leaving him extremely prone to hypoglycemia. Mason managed to eat a few cups of Jell-O and a bit of rice with yogurt, but otherwise slept through much of the day.
On the morning of the third day, Mason awoke nauseated, and tried to make it to the bathroom. However, his legs suddenly felt extremely heavy: he could not stand, and vomited in his bed. Hearing Mason's cries, his father rushed to his side and carried him to the bathroom, where Mason continued to vomit for an hour. Upon realizing that Mason still could not move his legs, his father immediately took Mason to the nearest hospital, almost an hour away from their quiet home. On the way, Mason oscillated between deep sleep, vomiting, and frantic questions: at times, he seemed extremely confused as to where they were going and who his father was.
Now it's your turn: Leave a comment guessing the patient’s diagnosis! If you have any questions, perhaps about the results from a test you as a doctor would run on the patient, feel free to pose those as well and I will answer to the best of my ability. I will not be replying to guesses about the diagnosis—only to questions about test results not listed here. Best of luck!
