Diagnoses you never thought you'd see?

[KarafromPhilly]

What's the most unusual patient you've ever had? I've had a couple--one was a woman whose admit orders included that she was NOT to have any food from home. They suspected that her husband was POISONING her.

The other was a woman who was a former LPN with a textbook case of Munchausen's syndrome. There was really nothing wrong with her but she kept insisting (moaning, actually) that she was SO sick. Very weird.

[asgirl]

Acute Hydrops. Originally thought to be conjunctivitis.

Unfortunately, very painful and it basically is left to run it's course unless the cornea ruptures then is an emergency corneal transplant.

[justmeinlv]

A 34 year old man with second degree burns to his butt. Negative for drug's and alcohol. The cause of burn was a bottle rocket that he lit himself.

[TiffyRN, BSN, PhD]

Pentalogy of Cantrell (infant born with 5 organs outside the body). After a long stay at a children's hospital, the infant went home allegedly fine.

Tetraploidy, the infant had 4 copies of each chromosome, 96 XXXX (instead of usual 46XX). This can happen when extra polar bodies don't discard as they are supposed to or fertilization of the ovum by multiple sperm. The infant was born alive but survived only hours.

What amazes me is when I hear of adults who never knew they had crazy bad heart defects and do fine for many years. Heart defects that are usually rapidly fatal.

[BackfromRetirement]

Cellulitis of the face.

[PetiteOpRN]

Patient had her pancreas removed due to acute pancreatitis and was on every drug the pharmacy carried...except insulin. And her blood sugars were normal.

We took her back to the OR frequently to pack the abdomen, and we looked for any part of the pancreas that was left behind and could find any.

Every time we brought her back, we had the same conversation:

"Is there a pancreas in there?"

"Nope"

"Have we discovered which of her other organs is producing insulin?"

"Nope"

"Huh."

[blondy2061h, MSN, RN]

Patient had her pancreas removed due to acute pancreatitis and was on every drug the pharmacy carried...except insulin. And her blood sugars were normal.

We took her back to the OR frequently to pack the abdomen, and we looked for any part of the pancreas that was left behind and could find any.

Every time we brought her back, we had the same conversation:

"Is there a pancreas in there?"

"Nope"

"Have we discovered which of her other organs is producing insulin?"

"Nope"

"Huh."

I've heard of a trial where doctors were transplanted islets to the liver when they had to do a pancrectomy for cancer or trauma or whatever other reason. It was having good success when I read about it. I wonder if this accidentally happened. I can't imagine she will continue to not need insulin forever. Very interesting.

[gentlegiver, ASN, LPN, RN]

I understand this is an old thread, but there were so many illness' I've never heard that I went thru it and wrote them down to look up when I get off AllNurses :)

[carolmaccas66, BSN, RN]

Nursed a lady who c/o extreme dizziness. Everything else in her life was normal, she talked normally, orientated to time & place, worked, had kids, hubby, etc. Had no history of any diseases, hypertension, nothing. But when she went to stand up she was so dizzy she nearly always fell over. Had a psych review, Drs thought it was psychosomatic - nope. She just felt dizzy when she stood (fast or slow). All bloods, tests done were normal.

Everyone was baffled. My theory was she just wanted a rest in hospital away from her family and her busy life - who knows?

[BackfromRetirement]

So inner-ear and r/o ataxia were eliminated?

[carolmaccas66, BSN, RN]

So inner-ear and r/o ataxia were eliminated?

From what I can remember (this was 20 odd years ago), she had seen every specialist and had every test done known to man. Maybe stress caused it?

[marielina85]

awesome thread....im still too green to have seen any of these abnormalities but maybe one day.

[Penelope_Pitstop, BSN, RN]

Cellulitis of the face.

I have seen that several times, actually.

Something I never thought I would see - Munchausen's. I figured I'd encounter Muchnausen's By Proxy at some point (which I haven't personally, but an RN at the local children's hospital is in jail for injecting her son with feces!), but for some reason never thought I would see Munchausen's itself.

It was a patient younger than I am, who had brittle diabetes to begin with, so he would cut himself and stick things in his wounds to get infections, skip his insulin and eat whatever. He also put foreign bodies in his eyes and one time tried to remove his own eye with a spoon (while on a MedSurg floor!) After that he became an automatic sitter case during every admission.