Saturday, June 06, 2009

Rare Diagnosis - Leishmaniasis

We had an interesting case lately. A young patient presented with prolonged fever, hyperpigmented skin lesions and hepatosplenomegaly. Lab study showed pancytopenia. Based on the clinical presentation and there is history of travelling, the physician made a diagnosis of Kala-azar (visceral leishmaniasis) right before much investigation.
And bone marrow aspiration with trephine biopsy was then done - Leishman-Donovan bodies were seen and consistent with Leishmaniasis.

All I can say is I'm thrilled by the clinical acumen.
According to him this is by far only less than 5 cases in the state. What a rare case it is!

And just to share one more thing that I saw in the clinic, when I asked one diabetic patient whether he brought his glucose monitoring diary, this is what he showed me:

He made a graph of his glucose level! Believe me this is only 1/20 of the full length as he has been doing it for few years.

And guess what's his occupation? Ya, a maths teacher! ;)

11 comments:

Zzzyun said...

wow i hope i will be able to be sucha good doctor as well! *salute*

btw the maths teacher pt very cute lah! at least we know tat he's concerned abt his health wic is good!

叶子 said...

Waw.... Kala-azar... never imagine it to be actually in real world(local settings).

Palmdoc said...

Just interested to see if Dr. Google can make the diagnosis
Google
and it's all over the first page

Darren Lee said...

Palmdoc: Ha cool..but it'll be easy after I summarized the findings la;)
In fact in our settings, myeloproliferative diseases and malaria is more common and must be considered as first few diagnoses.

li-shan said...

cool graph man! cool patient too! hahaha

Palmdoc said...

You don't get the rash in MPD and malaria though. Pigmentation in MPD can occur from the drugs used that said.

Darren Lee said...

Palmdoc: Ya..but in fact the skin lesions are very vague..not the typical ones. Quite difficult to pick up also;)

WinnieH said...

lol!! that maths teacher is cute!

Anonymous said...

interesting....

denise

cc said...

Dr. Darren > Google M.D.

jo an said...

think the math teacher can be a good example to other ppl. fantastic graph he made :D

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