E.R. case - what do you think?

[suckerfree]

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So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. The E.R. physician says he has no friggin clue what their problem is (which also kind of surprised me).

I saw this on TLC so if you want more details, sorry. But I'm just curious what some of you might think could be going on. I know that the case would be a lot easier with some of the details that you could get from a PE, but I saw this show on TV and was all pissed off at myself for not having figured it out.

 

[ChiefToma]

So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. .

The condition is a congenital disorder; most rookies miss this type of thing.....


The diagnosis is quite simple.

They are inbred. 😀 (quite common among carnies I believe).

 

[idq1i]

So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. The E.R. physician says he has no friggin clue what their problem is (which also kind of surprised me).

I saw this on TLC so if you want more details, sorry. But I'm just curious what some of you might think could be going on. I know that the case would be a lot easier with some of the details that you could get from a PE, but I saw this show on TV and was all pissed off at myself for not having figured it out.

PCP poisoning, some anticholinergic agent

 

[Portier]

Their problem is that they're carnies with small hands that smell like cabbage.....JK (that's from Austin Powers)

That's not a good report...don't give your attending one like that.

 

[DrChandy]

So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. The E.R. physician says he has no friggin clue what their problem is (which also kind of surprised me).

I saw this on TLC so if you want more details, sorry. But I'm just curious what some of you might think could be going on. I know that the case would be a lot easier with some of the details that you could get from a PE, but I saw this show on TV and was all pissed off at myself for not having figured it out.

Could be a case of late-stage Rabies virus infection.

 

[Mumpu]

Dang it Portier, beat me to it!

I saw the very beginning of that show. I believe they were found in some booth which would make them heat stroke patients. You cook someone enough and their body shuts down (absence of sweat is a very bad sign). If that's the case, they should not have been dunked in ice -- you can actually kill someone like that. Do you know if they all got 500 mg of levofloxacin too?

 

[DrChandy]

So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. The E.R. physician says he has no friggin clue what their problem is (which also kind of surprised me).

I saw this on TLC so if you want more details, sorry. But I'm just curious what some of you might think could be going on. I know that the case would be a lot easier with some of the details that you could get from a PE, but I saw this show on TV and was all pissed off at myself for not having figured it out.

Could be a case of the Rabies virus; fever and belligerance are key symptoms, including excessive salivation, and eventual paralysis when left untreated (non-responsive patient).

 

[Kathye42]

So a group of 4 male carnival workers, ages ranging from 20 - 50 present to the E.R. They are all have fevers of varying degrees and are completely crazy, one of them is unresponsive. They are of course, very beligerant as well during the process of being dunked in ice. The E.R. physician says he has no friggin clue what their problem is (which also kind of surprised me).

I saw this on TLC so if you want more details, sorry. But I'm just curious what some of you might think could be going on. I know that the case would be a lot easier with some of the details that you could get from a PE, but I saw this show on TV and was all pissed off at myself for not having figured it out.

They smoked something or used an hallucinogen

 

[suckerfree]

the NYMC student got it. Very simple...I was pissed becaue I missed the atropine fever and delirium. Atropine...mad as a hatter, hot as a hare, dry as a bone, blah blah blah. It was indeed anticholinergic poisoning. The workers went into the forest picking a plant (sorry, didn't catch its name) and they all overdosed after they prepared a tea from it.

The MD was confused because they all had the same sx. Pretty bad for the ER physician and for me who was reading this stuff not too long ago. Like my hero Kip says in Napolean Dynamite, "Dang it!"

 

[Portier]

I would have wanted more atropinization clues in the question stem....

maybe:
Constricted pupils
Rapid heartbeats
etc.

And maybe during the "crash" of them falling into the ER we coulda' gotten a tox screen. That would be my first choice when somethings "crazy."

That, and to call security.

 

[suckerfree]

Like I said, it was from an effing tv show and I gave all the clues that were presented on tv. I was just curious to see what anyone here would have said had they seen the same tv show.
No need to cry because you couldn't get it. Good job to the NYMC student. The rest of us should go study pharm some more.

I would have wanted more atropinization clues in the question stem....

maybe:
Constricted pupils
Rapid heartbeats
etc.

And maybe during the "crash" of them falling into the ER we coulda' gotten a tox screen. That would be my first choice when somethings "crazy."

That, and to call security.

 

[Portier]

I didn't mean it as a personal dig...sorry.

 

[Mumpu]

To catch the pupils and the heart rate, you actually need to perform a physical exam on a patient. Doesn't always happen.

 

[suckerfree]

I didn't mean it as a personal dig...sorry.

no problemo! Peace!

 

[liverotcod]

It was Jimson weed. I strongly dislike that program. Re-enactments with sententious pronouncements from the actors, like (from a doc to a nurse):

"Mr. Smith's pulse is 125, which is faster than normal. We call this tachycardia."

 

[rotatores]

You must be a first or second year b/c that was one of the worst presentation formats that I've ever seen...