Few weeks ago, we admitted a 38 year old with pneumonia. Fever, chills, white count, the works. Ground glass infiltrates,hypoxia, wheezing. She smoked about a pack a day so she got the COPD treatment. She didn't get better. I HRCT'd her. Took another history. She had a parrot that died suspiciously so hmmm--psittacosis? (chasing Zebras by this time). She got better, then got worse. Went back, took another history, quizzed her and her (lovely) family. She was a housewife, took care of her disabled child, lived in the outer burbs, etc. etc. I work part time so my partner took over. He persuaded CTS to do a VATS biopsy. (for some reason the pulm consultant didn't want to do anything,thought it was DIP,and threw more steroids at her.
It was PCP.
The whole point of this post being that if I had not sat face to face with this stay at home mom with her Norman Rockwell-esque family in the affluent outer New York suburbs, I would probably have dragged her off to the bronchoscopy suite myself, drowned her in Bactrim and sent her whole family off for HIV testing. I had seen more than enough cases during my training (in Harlem)
It stinks coming face to face with your own prejudice.
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Hindsight's often 20/20...
i took care of a very well dressed 30 yr old professional white male, happily married to beautiful woman, living in the 'burbs' came in with chest pain. ruled out. stress test neg. UDS came back positive for cocaine- i was dazed!!
have diagnised 80 year, married couples with HIV! so life is indeed strange!
She had a white count?
18K, or somewhere in that neighborhood.
Twenty years ago when AIDS was newer and I was a second-career nursing student, I recieved some invaluable advise from one of my professors.....
"You will NEVER get HIV from someone who LOOKS like they are HIV positive. It will be the well dressed business man in the Armani suit with 2.3 children and an SUV."
Pattie, RN
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