Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.
This week's hypothetical patient is an 8-year-old boy from a small, farming community in west Texas. He was admitted to the hospital in July with a fever, neck stiffness, muscle weakness, numbness, and intermittent tremors. He also reported having a headache and did not seem to know where he was upon examination. His parents are concerned that he could be experiencing complications from kidney issues that he had been treated for over a year ago. They stated that he had been playing outside a lot as it had been warm and sunny for the past several weeks. They remarked that he really enjoys fishing at the small pond on their property, despite the fact that he frequently comes home with mosquito bites. The physician ordered an blood test, which demonstrated an elevated immune response. The physician then ordered an MRI and a lumbar puncture. The results of these tests confirmed the physician's suspicions. The physician orders that the boy be put on intravenous fluids as supportive therapy and prescribes pain medication. She then discusses the boy's treatment options with his parents. There is no definitive cure for his condition, but there is emerging research showing positive results using interferon therapy or they can try to use IGIV or MGAWN1 therapies. There is also the possibility that with the currently administered supportive treatment, the boy's immune system could overcome his illness on its own. In the meantime, the boy is being monitored while the physician and the boy's parents weigh these options.
Thought Questions:
This week's hypothetical patient is an 8-year-old boy from a small, farming community in west Texas. He was admitted to the hospital in July with a fever, neck stiffness, muscle weakness, numbness, and intermittent tremors. He also reported having a headache and did not seem to know where he was upon examination. His parents are concerned that he could be experiencing complications from kidney issues that he had been treated for over a year ago. They stated that he had been playing outside a lot as it had been warm and sunny for the past several weeks. They remarked that he really enjoys fishing at the small pond on their property, despite the fact that he frequently comes home with mosquito bites. The physician ordered an blood test, which demonstrated an elevated immune response. The physician then ordered an MRI and a lumbar puncture. The results of these tests confirmed the physician's suspicions. The physician orders that the boy be put on intravenous fluids as supportive therapy and prescribes pain medication. She then discusses the boy's treatment options with his parents. There is no definitive cure for his condition, but there is emerging research showing positive results using interferon therapy or they can try to use IGIV or MGAWN1 therapies. There is also the possibility that with the currently administered supportive treatment, the boy's immune system could overcome his illness on its own. In the meantime, the boy is being monitored while the physician and the boy's parents weigh these options.Thought Questions:
What is the most likely diagnosis for this patient?
What is the underlying cause that leads to this condition?
Many people with this condition do not develop symptoms. What are some of the risk factors for the 1% of people who do develop severe symptoms?
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