A Medical Mystery
In our recent email newsletter we referred to a young lady who very nearly died while in our hospital. I would like to write a bit more about her case, since I believe many lessons can be learned from it. I'll call her "Y" for short. Y is a lovely 17 year old Honduran girl, from a mountainous village about 2 hours from our hospital. She presented to our emergency department with chest pain and shortness of breath. These symptoms had been present for 2 weeks at this point. In fact, Y had been a patient at a public hospital in La Ceiba (the nearest large city) for 12 days prior to coming to us. She had a chest x-ray that showed a right sided pneumonia with a pleural effusion (collection of fluid inside the chest cavity). Pneumonia with an effusion typically heals with appropriate antibiotics, and only occasionally requires fluid drainage. She had received antibiotics for over 10 days already, so why hadn't she recovered? Could I have the wrong diagnosis? Hardly! Did