12 February 2012


Every profession has its own language that tends to make it indecipherable to outsiders. I love the medical language; it's succinct and exquisitely precise. But then, I speak doctor, fluently. In my previous post, I left out lots of details because explaining them in everyday English would have made the post three times as long. But for the curious and the fluent out there, here's the untranslated version:

Day #1:
XX year old (gender) intubated and transfered to the unit secondary to AMS and hypercarbic respiratory failure c/b ARF while being treated for LLE L2 dermatome VZV. Concern for dissemination given RLE vesicles. DFA on RLE (-). Unlikely to represent dissemination, however AMS could be VZV encephalitis. LP not possible due to L2 vesicles and body habitus. Treat empirically for 21 days.

XX year old (gender) with recurrent hospitalizations for HA, n/v. Serial LP with pleocytosis, however HSV/VZV(-). Concern for chronic meningitis. Latest LP wnl. Unlikely to be chronic infectious due to lack of exposure history. Recommend steroids and rheum workup. d/c abx.

Day #2:
XX year old (gender) with newly dx UC refractory to steroids, now on Remicade. Blood cx with GPC in clusters, PICC tip cx w/MSSA. RUE DVT from previous PIV. May d/c vanc, start cefazolin. Blood cx remain (+), RUE U/S with abscess. Now dx of septic thrombophlebitis. I&D on RUE performed, cx remain (+). Recommend thrombectomy.

Day #3:
XX year old (gender) with Waldenstroms and chronic cough x 18mo. BAL in Jan (-) on AFB smear. Now (+) for M. gordonae. Febrile to 39.1 after second chemo infusion. BAL result likely contaminant; triple therapy not benign so recommend no tx unless sx. Cough dry, not consistent with mycobacterium. Fever likely transfusion rxn.

Day #4:
XX year old (gender) hospitalised in Jan for pna/chf, transferred due to vegetations on TV and RV pacer lead. Likely cx (-) endocarditis due to abx use. Continue vanc/zosyn and call EP for lead removal. Call CT surg for valve consult. Possible that pna was actually septic emboli 2/2 large TV veggie.

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