Answer 10

What is the possible diagnosis?

Discussions conducted by internal medicine residents:

-One opinion: "...patient most probably has some GI chronic or repeated infection which may be parasitic, especially small intestinal, causing malabsorption and this bad general condition...."

-Another opinion: "... I agree with the mentioned cause but I can mention another possibility which may be malignancy, especially intestinal lymphoma or any other system malignancy, which may explain the above manifestations...."

 

 

Watch carefully!

 

This constellation of symptoms either respiratory or gastrointestinal, with this abdominal distention, in such a poor patient directly brings to my mind the typical picture of intestinal tuberculosis which compelled me to start antituberculous treatment immediately, without waiting for investigation results, besides "resuscitation" of the patient due to her very bad general condition.

Now after institution of treatment for several weeks there has been a dramatic improvement in her general condition with relieve of all symptoms and abdominal distension: again the result of rapid, accurate and correct diagnosis with the suitable treatment is lifesaving.