This is what a patient learned after being dismissed by two physicians who missed his tularemia:
“If you go to the Dr. with some kind of fever and things like that and a few days later you’re not making progress just raise the roof and demand to have an infectious disease doctor on the case,” he said.
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{ 5 comments }
He’s right. An infectious disease doc should be stationed in every ER these days. As well as a hand surgeon, Neurologist, Rheumatologist, Dermatologist, podiatrist, Pediatric Cardiologist. “Just in Case” . Then when these uninsured patients who won’t even pony up a $10 co-pay coe in, we can order every test “just in case”. So they won’t sue our Butts. Man, I can’t wait till my canadian license comes through.
Tualremia has to be pretty rare in Alabama. RMSF maybe, lyme maybe, but Tularemia. Doesnt that come from infected rabbits rather than ticks? Obviously my ignorance is showing, but I never saw a case in my 5 years there.
I was tested for Q fever once, and hadn’t been out of a city for 10 years. Fear of litigation makes MD’s order some pretty strange tests.
Tick-borne illness in Alabama is not rare. Tularemia is one of those diseases and you can pick it up in Alabama.
Ignoring,or rather, scoffing at a history of tick bite at a patient who presents classically with fever, chills and shaking within 24-48 hours of a tick bite (in this case near woods inhabited with rodent resevoirs like rabbits and mice and voles) is just willful, intransigent stupidity.
Not ordering tests with a shotgun approach is admirable, but that hardly
was the case here.
“Most patients with fever don’t have a tick-borne illness” does not tranlate to “most patients who have fever and chills and shaking within 24-48 hours of a woodland tickbite” don’t have a tick-borne illness”
It’s called a clue. Apparently some ER docs aren’t paid enough to buy them.
It would not have been innappropriate to order a panel of tests for tick-borne illness, or to simply refresh ones knowlege database with a quick look-up to see how typical the patients presentation would be for tick-borne illness and what tests, if any would be appropriate.
“It’s called a clue. Apparently some ER docs aren’t paid enough to buy them.”
Glad you’ve spent so many years of working overnights and showing up to work with a waiting room filled with 50 patients waiting to be seen and you’re single coverage. But then again, since you easily disparage ER DOcs, I’ll retribute, of course you’re too stupid, you’re from Bama, probably the product of Consanguinuity.
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