Diagnoses you never thought you'd see? - page 3

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... Read More

  1. by   Marvie
    I was fortunate to see several very rare syndromes that are both fascinating and challenging. A young kid with MELAS, another with Noonan syndrome, and a little girl with cornelia-deLange syndrome. These kids are amazing.:redpinkhe
  2. by   rph3664
    Quote from kessadawn
    STDs in a 2 year old
    I've encountered that more than once. But the case of tetanus we had recently was just as tragic. The patient recovered but the incredible suffering was completely preventable.

    I once heard about a VBAC in a patient with exstrophy of the bladder, which was why she had the first c-section to begin with. She walked into the hospital ready to deliver, and did.

    One of my high school classmates has a child with Noonan's Syndrome. I had never heard of it, and a Google search took me to a website with a photo album, and I realized that when I worked in retail pharmacy, I had a family who had two children with it. The children clearly had some kind of genetic anomaly although neither was retarded (I actually think one of them was quite intelligent) and they looked just like these kids, who sort of look like they have Down's Syndrome but don't. In the accompanying stories, many Noonan's people are initially misdiagnosed at birth with Down's, because they commonly have a heart defect common in Down's as well in addition to the facies, but then the chromosome studies come back and they are 46xx or 46xy.
  3. by   crissrn27
    I've seen several interesting things, but thinking about it, I can't think of one that ended happily.

    I have seen two cases of necrotizing fascitis, one of the pt was a very young mother, so sad. Both died.

    One case of a really rare midline deformity, holoprosencephaly, undiagnosed with good prenatal care. Very severe case, with cyclopia, proboscis above the eye, very deformed. Parents loving decided to let the baby die naturally.

    A rare spinal tumor, a teratoma, on a newborn, that weighed more than he did. I think he weighed 3-7 and the tumor weighed 4-8. Died at about 48 hours of age, during surgery, I think.

    In nursing school I had a pt with tetanus, and older lady, died.

    This is depressing!

    Wait, I thought of one that did end OK, well, at least he didn't die. Sounds like the beginning of a joke but this woman came home and found her SO, umm, in the act with another woman. Don't know how she managed this but got a shotgun, loaded with buckshot, and nailed him in the groan. I really felt sorry for the guy, but at least he lived. My nursing instructor (I was in school at the time), made the suggestion, in all seriousness, that he contact the doctor that attended the Bobbitt case. Wonder if he did.
    Last edit by crissrn27 on Jan 28, '08
  4. by   saskrn
    My DH had a cross between Steven-Johnson's Syndrome and Toxic Epidermal Necrolysis. It was horrible and almost killed him.

    Also took care of a patient they suspected had Mad Cow disease (the actual name escapes me).
  5. by   Libitina
    Quote from saskrn

    Also took care of a patient they suspected had Mad Cow disease (the actual name escapes me).
    Creutzfeldt-Jakob disease

  6. by   jelly221,RN
    Quote from judy ann
    Having worked labor and delivery for many years, I have seen many anomolies. We had a cyclops (single eye in forhead) and a mermaid (different hospitals!)

    Thank God we had so very many healthy kids.
    are you serious??? whoa... man I hate to be that person who's fascinated by stuff like that, but unfortunately I am. I'll just have to learn to camoflage it when I'm a nurse I guess.
  7. by   rph3664
    I once lived in an area that had a large Central American and Southeast Asian immigrant population, and they had some really weird tropical parasitic diseases. One patient had symptoms of a brain tumor, and it turned out he had a worm encysted on the surface of his brain. It was removed, we had Biltricide flown in to destroy any residual parasites, and he walked out of the hospital 2 or 3 days later.

    At this same hospital, a 4-year-old was admitted with some ordinary problem and was discovered to have an STD. This hospital had the patient's address on the Addressograph, and someone said, "ABC Trailer Park. What do you expect?" and I replied, "There are people in XYZ Wealthy Neighborhood who are doing this." Probably true.

    We occasionally get people who were injured in meth lab explosions. I really hate hearing about those.
  8. by   SDS_RN
    I have not been a nurse for very long and i just xfered to the ED while on orientation we had a gentleman come in that had global transient amnesia. It was crazy he just kept asking his wife over and over again "Honey what happened? Where am I? What am I doing here?" He had just had a birthday the day before he came in and he did not remember it. He was fairly young just turned 51. He did recognize his family but was unable to recall any current events. He was put in the unit becasue I guess it only lasts for 12-24 hours. We did not feel comfortable letting him go home w/ family for fear he would wonder off. In November here the temps get pretty chilly. That's all I got so far maybe not so uncommon but first time I had witnessed it.
  9. by   NurseCard
    Quote from AmericanChai
    Eosinophilic esophagitis-- my daughter has this. I had never heard of it before her diagnosis. Basically you are allergic to all food or most food and survive on elemental formula for life in the more severe cases.
    I have a friend who's 3 year old son has this... I THINK he's three...

    I have also had a patient who was suspected to have Munchausen's Syndrome. She was a young woman (20's) who had been born with heart defects, had had surgery, and now was on Coumadin for the rest of her life. She would come to the hospital multiple times with her INR allllllllll out of whack. She would moan and groan, ohhhhh woe is me....
    her heart doctor really thought that she HAD to be purposefully taking too much Coumadin.
  10. by   saskrn
    I've seen Munchausen too.
  11. by   Simplepleasures
    Quote from saskrn
    My DH had a cross between Steven-Johnson's Syndrome and Toxic Epidermal Necrolysis. It was horrible and almost killed him.

    Also took care of a patient they suspected had Mad Cow disease (the actual name escapes me).
    I too have taken care of a patient with Creutzfeldt Jacob disease. The associated dementia in this patient was so different than the Altzheimers, or other types of dementia Ive seen over the years. I actually had a scare once with this patient, when a tiny drop of of gastric juice splashed onto my lip, from the G-tube .I was SO paranoid that I would catch this devastating disease.

    The other thing Ive witnessed was breast CA, that had grown so large it broke through the skin, it was really awful, but the dear old lady did not seem to be in any discomfort, strange, huh?
    Last edit by Simplepleasures on Jan 28, '08
  12. by   siggie13
    19 yr old with prostate cancer.

    3yr old with rabies.

    Several cases of tetanus in children.

    Had a case of a 10 year old boy who came into the hospital, died in one day and the autopsy showed worms in all his major organs.

    Penile CA in a young man.
  13. by   rph3664
    My old boss had a relative who got really sick one day, went to the ER thinking he was having a stroke, and within a day or two had lapsed into a coma and died. Long story made short: We all believed the hospital was sitting on a multi-million dollar malpractice suit, then the autopsy and lab results came back and he turned out to have a type of leukemia that is diagnosed about 5 times a year in the United States, and they have never come up with a chemo regimen for it because nobody has ever lived long enough for them to do so.

    I don't remember what it was called, but most doctors obviously never see a case of it.