Minor point, Salinas is in the Salinas Valley, not the Central Valley. I am aware of a case of cocci in Monterey County some 45 years ago during a large wind event which blew dust into the Salinas Valley. Would be interesting to know where she spent the night in Tahoe. Finally, would retained products of conception be on the differential diagnosis early in the workup phase?
The diagnostic test result appears momentarily on the screen at 48:02. I am not sure why they didn't discuss it. I was presented a very similar case with the same dx a few years ago in "stump the chump" rounds, and this is a very challenging disease to diagnose. I had the benefit of a more detailed and helpful history than was given in this case.
@@jonb8166 Kudos to the person who ordered that test. In my experience, it's not in the usual panel of studies recommended by ID. We had a similar case at LA County about 15 years ago where the actual diagnosis was not in anyone's differential, but blood cultures grew Yersinia pestis.
Surprised not to see a glucose. Surprised not to hear anything about any kind of covid test (unless they just knew it was not covid). First or second thought of mine - retained product of pregnancy. Probably way off base esp after 5 months.
I love clinical medicine. This case discussion is so insightful. We'll be doing the same here in Africa
Very interesting presentation!
Minor point, Salinas is in the Salinas Valley, not the Central Valley. I am aware of a case of cocci in Monterey County some 45 years ago during a large wind event which blew dust into the Salinas Valley. Would be interesting to know where she spent the night in Tahoe. Finally, would retained products of conception be on the differential diagnosis early in the workup phase?
Excellent and interesting presentation. Thank you.
Was the diagnosis made by blood test? How long after the pt recovered was the diagnosis made?
The diagnostic test result appears momentarily on the screen at 48:02. I am not sure why they didn't discuss it. I was presented a very similar case with the same dx a few years ago in "stump the chump" rounds, and this is a very challenging disease to diagnose. I had the benefit of a more detailed and helpful history than was given in this case.
@@jonb8166 Kudos to the person who ordered that test. In my experience, it's not in the usual panel of studies recommended by ID. We had a similar case at LA County about 15 years ago where the actual diagnosis was not in anyone's differential, but blood cultures grew Yersinia pestis.
Surprised not to see a glucose. Surprised not to hear anything about any kind of covid test (unless they just knew it was not covid). First or second thought of mine - retained product of pregnancy. Probably way off base esp after 5 months.