A scene right out of House, M.D.

For the record, I don't really watch House, but I've seen enough episodes to get the gist of it. Dr. House is confronted with an unknown illness that no one can figure out. He assembles his special team of doctors to brainstorm possible solutions while popping Vicodin. In the course of the hour-long show, Dr. House seems to antagonize as many coworkers as possible in pursuit of the elusive diagnosis, which is usually some bizarre and highly unlikely string of illnesses. Looking back on today, I think Dr. House would appreciate one of the cases we saw.

Today Donna and I made rounds with Dr. Joshi, the head of the pediatrics department at DMH. This was the third day in a row that we've done this, so we got to see how some of the patients progressed. There was one interesting case in particular that we saw today. Several weeks ago, the boy came in with a high fever. After examining his other symptoms and testing his blood samples, the diagnosis was typhoid fever.

They gave the boy antibiotics, which initially started working. However, after he became unresponsive to the antibiotics, they gave him a stronger antibiotics, but without any significant change. In addition, he started displaying other symptoms, including jaundice and abdominal pain. In essence, it appeared that instead of making the boy better, the antibiotics were making him worse! As those of you with medical knowledge may be aware, those additional symptoms are characteristic of Hepatitis (inflamation of the liver). Sure enough, after testing, the boy's results came back positive for Hepatitis A.

There is no cure for Hepatitis A--simply plenty of rest and lots of fruit juice (apparently because having the fructose gives the liver extra stores of sugar). Yet the question remained--how did the boy get Hepatitis? The answer lies in the incubation periods--Hepatitis A has a much longer incubation period than typhoid fever. Thus, the boy was probably only infected once, since both illnesses are contracted through contaminated food. The boy came to the hospital only with symptomatic typhoid, but as his hospital stay progressed, the Hepatitis A became symptomatic as well.

I'm quite sure that Dr. House would have come to the same conclusion. However, I have to say that Dr. Joshi was able to diagnose this boy's problem without a team of internists brainstorming for him and without irritating all of his coworkers!