Tuesday, October 13, 2009

On Being Immunocompromised

We were discussing about a case of acute gastroenteritis (AGE) the other day. In layman's term, food poisoning, where there'll be diarrhoea and fever and sometimes vomiting. Although medically speaking, acute gastroenteritis might have other causes other than food, but true enough, it almost comes from what we eat most of the time.

That day, I learnt that diabetic patient could have AGE as well. It's called diabetic gastroenteroparesis. Bombastic. Me likey.

I also learnt that the amount of stool in viral cause of AGE reduces over time while that of bacteria cause remains to be in large amount.

I learnt that some atypical pneumonia caused by Legionella could also cause AGE.

I learnt that in patient with AGE, it is somewhat important to ask about the social status, or more precisely, who the partner is.

I was somewhat surprised when the Dr. asked my colleague whether the patient's partner was a male or a female. The patient was a male, and stays with male housemates, mid 30s, not married, no girlfriends. Ringing a bell? He said a few years back, there was a patient who was admitted because of subacute AGE, which had lasted for a few weeks before he was admitted. The HOs clerked him. The MOs clerked him. The specialists and consultants seen him. And it wasn't after a while when they finally did a retroviral screen and he was found to be postive. Apparently, in immunocompromised patients, i.e. in this case where the patient is HIV positive, they're more succeptible to opportunistic infections which, non-immunocompromised patient would not get. And, there are some which manifested with prolonged diarrhoea.

So... yeah. That's what I learnt... Although I doubt I'd get that piece of information if I were to clerk that patient myself. Most often than not, if you tell me: diarrhoea, fever, vomiting, stomach ache, the first thing that comes into mind, AGE.

And I admit, my brain works too slow or simply don't work at all in thinking further what could possibly cause it... Ugh... My brain's compromised.

Did I mentioned I think I have irritable bowel syndrome? Here's a piece of cartoon to spoil your appetite.

11 Jujus:

TZ said...

hmmm... you really popular with disgusting piccie... i just had my soupy noodles lunch... now feel like vomiting ... :p

[SK] said...

i have not had my lunch yet, and well, that pic didn't spoil my appetite at all.. haha!!

Little Dove said...

Kane looks kinda cute!

Danny said...

IBS !!! my doc used to told me that i have that long time ago..and i felt kinda proud.. cos the name oso seems like very canggih...heheh ;p

cpl said...

how does knowing sexual orientation determine if the patient has HIV or not? i thought u were going to say amoebiasis or something :P

manglish said...

it seems that HIV infection is on the rise or u just sort of highlighted those cases which are bcs i remember you have several posts regarding illness associated with being immunocomprised in patients with HIV....

Medie007 said...

TZ, thank you thank you. :P i'm flattered. kakaka. :P

[sk], u're one man hard to 'please' LOL

little dove, he's dead wor... LOL

Medie007 said...

Danny, i know! me too feel like it. but then hor, when the diarrhoea comes u'll wish to kill to get it stopped lor...

cpl, well, knowing their sexual orientation somehow puts them in risk of being hiv positive, and thus put them in a higher chances of getting all sorts of opportunistic infections. stool culture prolly come out negative in that earlier case because that patient was under investigation for the cause of prolonged diarrhoea for weeks before they do the retroviral test and found out he's positive. maybe only then they did a specific serology test or something.

manglish, yeaps it is on the rise. and yeah, prolly i've been highlighting it quite often as well. maybe perhaps i take an interest in hiv. perhaps i should consider going into infectious disease eh? :P

Gratitude said...

Good post lil doc. Now we have further knowledge of another complication arising from being HIV+.

manglish said...

you should and become the successor of tat malay lady...wat's her name? something kamaru....something something hahhaha....

said...

do u knw why i didn't read ur blog so often these days? coz u always post all these disgusting pic which make me loss all my appetite :(

arrggghhh~