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#53 - Assumptions Do One Thing...

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#61 TexRNmedic


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Posted 14 June 2010 - 02:49 AM

This really was a great study Jason. Thanks for taking the time in the midst of everything else you have going on. Hope your kiddo keeps heading in the right direction.

TORCH or TORCHES= TOxoplasmosis, Rubella, Cytomegalovirus, HErpes simplex, Syphilis. Usually passed down perinatally. I'm sure his immunization status is questionable at best. Good group of differentials. I'll definitely start filing that group a little closer to the front.

I have had the rabies IG and vaccine series and now ALWAYS wear eye protection when performing airway management thanks to a similar story. The patient came through a psych facility, suburban ED and tertiary hospital a couple of time before the dx was ever made. Dx was made after someone mentioned the patient "looked rabid" and was tested. Exposure to rabid mammalian about a month prior unknown to family. Plasmapheresis, IG and high-dose Medrol were unsuccessful. The poor epidemiologists had a field day trying to find everyone potentially exposed. Easy to miss without a very, very good history. Unfortunately, once symptoms are this severe, there really isn't much that can be done.

Looking forward to the next study guys. Very well done and had some great back-and-forth discussions. Be happy to help with future studies where ever I can. I'm pretty good with cooking up labs to fit the picture too.
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Wes Seale
Houston , TX