Two days, two patients. The first is middle-aged and looks uncomfortable lying on his back. He was brought in unconscious and feverish. His hands are shaking despite the green restraints tied around his wrists. Lots of patients in the hospital have restraints such as these: there are no sidebars on the beds and hospital staff worry that they may fall off. Back to our patient. He has a big liver, and his skin bears an appropriate yellow tinge. I begin to list in my mind the viruses, bacteria and fungi which can cause liver failure.
Our second patient is much older, and much sicker. Similarly restrained for his protection, he is fast asleep, snoring, seemingly oblivious to the anxiety he is causing the pack of doctors gathered around his bed. An NG tube feeds him, while a ventilator attached to his tracheostomy breathes on his behalf. Despite the big liver, this patient isn't yellow. Admitted with fever, cough and difficulty breathing, he was found to have a bad chest infection; subsequent tests reveal the space around his lungs has filled with blood. His chest X-rays give us plenty to talk about.
Despite my list of microbes which target the liver, I'm wide of the mark (a pattern is emerging). Both alcoholic, these patients' ailments are self-induced. Their livers have suffered for years and are finally giving in. Unfortunately, I don't think a transplant is on the cards.
In the Hospital for Tropical Diseases, I could be forgiven for thinking that every presentation has an infectious agent behind it. But the source of both these patients' problems is not a tropical bug, it's a bottle.
Our second patient is much older, and much sicker. Similarly restrained for his protection, he is fast asleep, snoring, seemingly oblivious to the anxiety he is causing the pack of doctors gathered around his bed. An NG tube feeds him, while a ventilator attached to his tracheostomy breathes on his behalf. Despite the big liver, this patient isn't yellow. Admitted with fever, cough and difficulty breathing, he was found to have a bad chest infection; subsequent tests reveal the space around his lungs has filled with blood. His chest X-rays give us plenty to talk about.
Despite my list of microbes which target the liver, I'm wide of the mark (a pattern is emerging). Both alcoholic, these patients' ailments are self-induced. Their livers have suffered for years and are finally giving in. Unfortunately, I don't think a transplant is on the cards.
In the Hospital for Tropical Diseases, I could be forgiven for thinking that every presentation has an infectious agent behind it. But the source of both these patients' problems is not a tropical bug, it's a bottle.
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