Saturday, September 30, 2006
Does This Girl Look Sick?
As stated in a previous post, tuberculosis can be a very sneaky disease.
This young Haitian girl does not appear to be sick especially if you saw her walking down the street and knew nothing about her history. But listening to her left chest with a stethescope revealed an abscence of breath sounds due to a large pleural effusion. A pleural effusion is fluid that collects in the pleural space surrounding the lung. This fluid has also pushed this girl's heart to the right because fluid is not compressible and so something has to give.
Most likely, this fluid is caused by tuberculosis. A hypersensitivty reaction occurs which frequently causes the effusion to form. She is Haitian and physicians have to know what is prevalent and endemic where they practice. If this girl were from Peoria, and had not travelled recently, and had no contacts with adults with tuberculosis, I would not think she has tuberculosis. Unfortunately for her, she lives in Haiti, where getting tuberculosis is almost expected.
I referred her for 8 months of tuberculosis treatment. Her chances for cure are greater than 90%.
A Haitian proverb says, "One sees from where one stands."