Curious Cases in Care: Can You Guess the Diagnosis?

Marshall Miller: 
I'm Marshall Miller, and I'm on the case with another episode of Rub Some Dirt In It. There's a TikTok account where a young doctor has 60 seconds to come up with a likely diagnosis based on the simulated patient's symptoms. They narrow it down like a flowchart until the time is up and they have to give an answer. I actually haven't seen one yet where they get it wrong, but I have found two cases where they were short or run out of time.

From The New England Journal of Medicine, a 28-year-old woman in the UK presents with a severe eye infection with no obvious indicators. Typical antibiotics were no help, but through a thorough history, it was revealed that the patient's cat had developed some odd lesions on its paws recently. Testing revealed that the cat and the patient were both positive for cowpox. A little tecovirimat from the U.S. National Stockpile most frequently used to treat smallpox, cured the patient in no time. Utterly fortunate one might say.

From BML Open Gastroenterology, a 46-year-old who claimed he never drinks alcohol complained to his physician of what he described as drunken incidents. He was even arrested at one point for drunk driving with a blood alcohol content way over the legal limit, but he maintained he did not drink. The diagnosis? Automated brewing syndrome. This condition occurs when yeast in his intestine converted carbohydrates into wine. The treatment of antibiotics paired with some probiotics made his munching on a baguette possible again without turning it into a Chateau Lafite Rothschild, of sorts.

So cowpox and belly wine mysteries aside, if you've got a tough case, you can always rub some dirt in it. This was another Rub Some Dirt In It Minute, or Two.

Thanks for listening.