Diagnostic Dilemma

I had a call today from a friend of mine - patient with 9 months history of head ache and vomiting presenting with "meningism". (Clinical Signs of Meningitis). CSF (Fluid surrounding the brain) studies normal. the consultant was not sure what he was dealing with. to add to this, the patient was HIV positive....

Diagnostic dilemma's are not unusual in Medicine. Dilemma occurs when clinical signs point to one diagnosis but investigations do not support the same.

With a pre-existing illness some of the dilemma are more complex. you need second opinion from more experienced clinicians to sort out dilemma like these! And that was the expectation from me - but at the end of the consult all I could give was a few differential diagnosis - could be 1 - Crypto 2 TBM 3 Toxo 4 Lymphoma etc.....A final diagnosis could only be possible by identifying the "fungus" or Bacteria" - the root cause....for which the patient had to be referred else where....for a closer scrutiny...which would be expensive and in another location....

The white washed sepulchers which Jesus talked about would have been a diagnostic dilemma for the common man - externally signs of "spirituality" but internal - one can not come to a clarity because what you see is not what is expected....

Referral services are required to sort out this diagnostic dilemma of our lives...Routine investigations may not give clue, but the "closer scrutiny by the Spirit seems to be the only way of diagnosing this "inner outer divide..."

The good side of this is that you do not need to go far or spend too much for this closer scrutiny, it is close at hand...all you need is an open heart....and a willing soul....

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