Lecture Notes: Medical Case Presentation

Introduction

• Discussion about a patient (Foreman) with a mysterious illness.
• Urgency surrounding the diagnosis.

Autopsy Discussion

• Debate on performing an autopsy on Joe to find out what is killing Foreman.
• Concerns about bio safety levels and proper equipment for autopsy.
• Mention of contacting the CDC and delays in getting results.

Diagnosis Challenges

• Foreman is critically ill, with only 36 hours to diagnose and treat him.
• Possible causes of illness: a toxin, contagion, or an unknown disease.
• Need to consider different methods for diagnosis rather than immediate autopsy.

Medical Procedures

• Consideration of an ice pick lobotomy as a method to obtain a sample.
• Ethical considerations and the risks involved in such a procedure.
• House emphasizes the urgency of acquiring a brain sample quickly.

Treatment Discussions

• Discussion about various medications and treatment protocols.
• Importance of monitoring Foreman’s symptoms and adjusting treatment accordingly.
• Identification of high levels of amylase and lipase in blood work, indicating possible complications.

Investigation Findings

• The course of Foreman's illness mirrors Joe's but is progressing faster.
• Examination of Foreman’s medical history for conditions that may affect disease manifestation.
• Suggested testing for infections with documented racial disparities.

Conclusion: Leading to Diagnosis

• Consideration that Foreman’s rapid decline might be due to a different strain of the same disease.
• Discovery of potential bacterial infections (e.g., listeria) that affect humans but not rats.
• The hypothesis that exposure to a second infection might trigger the body’s immune response, worsening the primary infection.

Future Actions

• Plan to administer antibiotics and potentially perform a deeper brain biopsy.
• Anticipation of needing to act quickly as Foreman's condition evolves.
• Final discussion surrounding the importance of timely and accurate treatment.

Additional Notes

• House's unconventional methods and willingness to take risks for diagnosis.
• Ethical implications of medical decisions and urgency in life-threatening situations.