Sunday, 26 November 2017

PUZZLE OF SYPHILIS IN A THREE YEAR OLD

Common things are common and vice versa . This slogan is an aid to making diagnoses in medicine but the challenge is when uncommon things dare your medical prowess and sometimes leave you more confused than the patient. This was so in Daniel's case.

To be super-parents we need the eyes of an eagle, the team work of the 300 Spartans, the gentleness of the lamb and the wisdom of the serpent. Daniel is three years old and was brought to the clinic on account of recurrent fever and malaise. After a round of clerking the physician made a diagnosis of Poorly treated Malaria and commenced him on a more appropriate antimalaria medication.

After a week Daniel was brought back to the clinic with worse symptoms of generalised body rash and lympadenopathy (lymph node swelling) in addition to the earlier symptoms. At this juncture , the physician's tentacles were raised, at first he thought of measles but the more he dug into it, the more uncertain it became, he also thought of a possible HIV infection and lymphoma . On inspection of the patient, he found a wart-like growth on Daniel's scrotum which got him confused the more. He stood still for a while pondering over his findings, looking for a clue but his brain was blank and the mother kept asking him what the problem was with her son.

The patient was admitted and some investigations sent while palliative treatment was commenced but when the results were retrieved it wasn't any of the diagnosis he had in mind. Then he turned to the mother and asked her the million dollar question, the blow that broke the back of the camel, 'Madam, was there anytime within the past six weeks that your child had a rash on his penis'? Looking into his eyes as though he was a prophet with hope and confidence restored in her she gave him a nod and added that it didn't disturb her child but eventually resolved spontaneously with hich made her attach zero importance to it . He quickly pulled a leaf of investigation sheet lying like a comatosed patient and filled for VDRL test. The result came out positive but it did not go down well with Mrs. Gladys Oruada after the doctor explained the result to her and requested that she and her husband be tested as well.

It was the battle of Muzanga that evening when Mr. Uche Oruada returned from work, he received a cold welcome from his wife who was filled to the brim with suspicion and waiting in the bedroom to kick start the Amagedom. His confusion was interpreted as pretence. She unleashed hell on him that night, calling him a cheat, a womaniser, a wolf in sheep skin, a syphilis distributor, blablabla.... Mr. Uche had never seen his wife in this mood in the past eight years of their marriage, he was so disappointed but he managed to get a grip on his temper less he beat her blue black. The matter was laid to rest temporarily when the couple agreed to run the test but she refused to spend the night with her husband in her bedroom.

That night Mrs. Gladys after two hours of sleep walked up the stairs leading to her bedroom. She could hear loud moaning from that direction and as she drew closer the noise became louder. She opened the door and caught her husband ramming their house help, Ivie, from behind. Filled with rage, she picked up a wine bottle and flung it at them hoping to fracture their brainless skulls. The cracking sound woke her up and she realised it was just a dream and that she had smashed the flower vase in the sitting room against an aquarium.

No breakfast was served the next morning, both of them wearing long faces, no one uttered a word to the other, they just went their separate ways to the clinic to have the test done.
Life was no longer at ease for Mr. & Mrs. Oruada, their once peaceful home has become a theatre of war. Her husband started keeping late nights, the children, unhappy and miserable and the wife filled with bitterness and recked.
The doctor called the couple when the result was ready and both went with great expectations and anxiety . Mrs. Gladys was convinced within her that her husband would test positive but on the contrary, he didn't, neither was Mrs. Gladys positive to the test.
How then did Daniel get his Syphilis? Stay connected to find out in next episode. Let me know your thoughts in the comment box. Thank you so much for reading!

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