Today was one of our last "lectures" in microbiology and instead of being talked at for another hour, we got to play to role of a (really bad) detective. The guest lecturer was a doctor who turned off the Powerpoint, and simply had us try to unravel a mystery. We were given an incredibly vague history of a fake patient and then were prompted to ask questions until we figured out what the patient had.
It was very slow going, but by using the facts we've learned this semester, we were able to come to a diagnosis of TB. Apparently TB has such varied and complex constellation of possible symptoms, that it should always be somewhere on one's differential diagnosis.
This was weird and awkward at first, but eventually very rewarding just to see how much we had grown this semester. We didn't immediately figure out the cause of the infection, but we knew how to rule-out some of the hundred of potential causes we had learned in the past few months. If someone asked, "Does the man have pets?" or "Are his lymph nodes swollen?" everyone knew the slew of diseases that the questioner was trying to rule in/out from that line of questioning. I'm calling that progress!
TIL: If a heroin user shows up at the ER with a fever and a chest x-ray showing a patchy infiltrate of the lungs, think staph aureus! This bug is found on the skin and enters the venous drainage via the heroin needle track marks. From there, it infects the heart, specifically the tricuspid heart valve, causing endocarditis. That infection of the valvar surfaces can cause chunks of virus-infected material to break off from the damaged valve and get caught in the lung, resulting in a patchy infection of the lung.
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